Влияние ассоциированности опухоли с вирусом папилломы человека на результаты иммунотерапии у пациентов с рецидивным и метастатическим плоскоклеточным раком головы и шеи

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Аннотация

Вирус папилломы человека (ВПЧ), преимущественно 16-го (реже 18-го) типа, ассоциирован с развитием плоскоклеточного рака ротоглотки (ПРР). Согласно данным литературы, от 25 до 70 % всех случаев данного заболевания связаны с ВПЧ-инфекцией. В США и некоторых странах европейского союза частота ВПЧ-ассоциированного ПРР достигает 60-70 % всех случаев плоскоклеточного рака головы и шеи. Для ВПЧ-положительного ПРР характерны благоприятный прогноз и более высокие показатели выживаемости по сравнению с ВПЧ-отрицательным ПРР. Эти варианты данной патологии по-разному классифицируются в Tumor, Nodus and Metastasis (TNM) 8-го издания. Значительная разница в показателях выживаемости и прогнозе заболевания стала причиной проведения исследований, направленных на изучение возможности деинтенсификации стандартного лечения ПРР с целью минимизации нежелательных явлений без потери эффективности. Несмотря на более благоприятное клиническое течение, у 15 % пациентов с ВПЧ-ассоциированным ПРР даже после стандартной терапии развиваются рецидивы и/или регионарные/ отдаленные метастазы, что связано с неблагоприятным прогнозом. Современные схемы лечения рецидивного/метастатического плоскоклеточного рака головы и шеи включают иммунотерапию, результаты которой также могут зависеть от ВПЧ-статуса опухоли. Несмотря на то что в клинические исследования, посвященные изучению эффективности иммунопрепаратов, входят пациенты с ВПЧ-положительными опухолями, данные о результатах лечения являются неоднозначными, к тому же молекулярные механизмы влияния ВПЧ на иммунный ответ в полной мере не изучены.

В статье обобщены данные о влиянии положительного ВПЧ-стасуса на эффективность иммунотерапии пациентов с прогрессирующим/метастатическим плоскоклеточным раком головы и шеи.

Об авторах

А. В. Игнатова

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России; ФГАОУ ВО «Российский университет дружбы народов»

Автор, ответственный за переписку.
Email: annasurge@gmail.com
ORCID iD: 0000-0002-6796-0968

Игнатова Анастасия Валерьевна.

115522 Москва, Каширское шоссе, 24; 117198 Москва, ул. Миклухо-Маклая, 6

Россия

Ю. В. Алымов

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России

Email: fake@neicon.ru
ORCID iD: 0000-0002-6851-9867

115522 Москва, Каширское шоссе, 24

Россия

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