Анапластический рак щитовидной железы. Есть ли свет в конце туннеля?

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Анапластический рак щитовидной железы – одна из самых прогностически неблагоприятных опухолей. Такой прогноз обусловлен быстрым увеличением размеров первичной опухоли с тенденцией к развитию асфиксии и быстрым появлением отдаленных метастазов, а также низкой эффективностью рекомендованных схем лечения. Эти схемы, ставшие результатом многолетних усилий онкологов всего мира и включающие в идеальном варианте хирургическое вмешательство, химиотерапию и лучевую терапию, не дают удовлетворительных результатов, а продолжительность жизни пациента после их применения нельзя назвать достаточной. Развитие представлений о молекулярно-генетических особенностях опухолей, в том числе анапластического рака щитовидной железы, предоставило нам информацию о двух возможных особенностях генетического аппарата опухолевых клеток, имеющих, предположительно, клиническое значение: мутации V600E в гене BRAF и слиянии генов NTRK. Описанный в данной статье клинический случай как раз послужит, вероятно, первой в России иллюстрацией эффективности анти-BRAF-терапии у пациентки с анапластическим раком щитовидной железы. С нашей точки зрения, польза данного примера заключается в демонстрации не только эффективности современной таргетной терапии, но и отсутствия необходимости отказываться от иных методов лечения, в данном случае от облучения области первичной опухоли (а в других случаях, по аналогии с этим, – и от хирургического удаления опухоли при условии ее резектабельности).

Об авторах

А. Л. Пылев

ООО «Центр инновационных медицинских технологий»

Автор, ответственный за переписку.
Email: fake@neicon.ru
115191 Москва, Духовской пер., 22б Россия

А. А. Жандарова

ООО «Центр инновационных медицинских технологий»

Email: fake@neicon.ru
115191 Москва, Духовской пер., 22б Россия

К. С. Петров

ООО «Медскан»

Email: fake@neicon.ru
ORCID iD: 0000-0002-0997-7825
125195 Москва, Ленинградское шоссе, 47 Россия

Д. С. Романов

ООО «Центр инновационных медицинских технологий»; ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России

Email: romanovronc@gmail.com
ORCID iD: 0000-0003-3942-4102

Денис Сергеевич Романов 

115191 Москва, Духовской пер., 22б Россия

В. А. Лисовой

ООО «Центр инновационных медицинских технологий»

Email: fake@neicon.ru
ORCID iD: 0000-0002-0384-0596
115191 Москва, Духовской пер., 22б Россия

С. В. Голуб

ООО «Медскан»

Email: fake@neicon.ru
ORCID iD: 0000-0002-6171-5128
125195 Москва, Ленинградское шоссе, 47 Россия

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