Этиология, эпидемиология, стратегии и причины низкой эффективности лечения светлоклеточного почечно-клеточного рака

Актуальность. В основе возникновения почечно-клеточного рака (ПКР), в том числе и светлоклеточного почечно-клеточного рака (сПКР), лежат различные генетические изменения, которые на данный момент не поддаются корректировке. Этот факт делает актуальным изучение генетического профиля сПКР и биомолекул, вовлеченных в реализацию генетических изменений, что может стать основой для разработки таргетных терапевтических стратегий. Цель исследования – проанализировать и обобщить научную литературу, описывающую современные стратегии терапевтических подходов в лечении ПКР и причины низкой эффективности биологических методов лечения. 
Материал и методы. Проанализированы результаты поиска по научной базе данных PubMed и научной электронной библиотеке elibrary.ru по следующим ключевым словосочетаниям: renal cell carcinoma (ПКР), clear cell renal cell carcinoma (сПКР), molecular biomarkers and clear cell renal cell carcinoma (молекулярные биомаркеры и сПКР), multi-omic profiling and renal cell cancer (мультиомиксный профиль и ПКР), signaling pathway and renal cell carcinoma (сигнальные пути и ПКР), stem cell subtypes and clear cell renal cell carcinoma (стволовые клетки и сПКР), treatment strategies and renal cell carcinoma (терапевтические стратегии и ПКР), в качестве основных справочных источников взяты обзоры и оригинальные исследования, в основном публикации за 2020–25 гг. по каждой тематической области. Статьи, содержащие дублирующуюся или значительно перекрывающуюся информацию, были исключены. Отобрано 79 актуальных публикаций зарубежных и отечественных авторов за период с 2020 по 2025 г. 
Результаты. Наиболее изученными генетическими изменениями при ПРК, в том числе и при сПКР, являются гены-супрессоры VHL и BAP1. Среди терапевтических стратегий применяются различные ингибиторы тирозинкиназ и ключевых точек иммунитета, также продолжается поиск новых точек (гены, сигнальные молекулы, белки) как потенциальных стратегий новых терапевтических подходов. 
Заключение. В патогенезе ПКР, в том числе и сПКР, существенная роль принадлежит геномным нарушениям, при выборе тактики терапевтической стратегии лечения больных ПКР следует ориентироваться на результаты эффективности биологических методов лечения, по данным ретроспективных исследований, а также на эффективность лечения иммунного микроокружения опухоли, экспрессии на поверхности опухолевых клеток молекул, способных снижать действие лекарственных препаратов.

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