Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya27035ArticlesСтатьиResearch ArticleChoice of anti-angiogenic agents in second-line treatment in patients with metastatic colon cancer: bevacizumab, aflibercept, ramucirumab (a literature review)Выбор антиангиогенного препарата во 2-й линии терапии больных метастатическим раком толстой кишки: бевацизумаб, афлиберцепт, рамуцирумаб (обзор литературы)FedyaninM IuФедянинМихаил Юрьевич

канд. мед. наук, врач-онколог отд-ния клин. фармакологии и химиотерапии ФГБУ РОНЦ им. Н.Н.Блохина

Fedianinmu@mail.ruN.N.Blokhin Russian Cancer Research CenterФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России15092015173VOL 17, NO3 (2015)ТОМ 17, №3 (2015)818709042020Copyright ©; 2015, Consilium MedicumCopyright ©; 2015, ООО "Консилиум Медикум"2015Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/27035

Over the last decade, the possibility of the drug therapy for patients with metastatic colon cancer (mCC) has increased due to the targeted drugs, because most of those drugs have had antiangiogenic activity (bevacizumab, aflibercept, ramucirumab, regorafenib). The combination of chemotherapy and bevacizumab, especially in the patients with mutations in the EGFR signaling pathway, is one of the standard therapy variant in first-line treatment of such patients. However, sooner or later, most patients will develop progression, and no one can say what kind of drugs will be added in 2nd-line treatment in this case. The subject of this review is the difficulty of choosing the sequence of therapy in patients with mCC using antiangiogenic drugs in first-line therapy.

За последнее десятилетие возможности лекарственной терапии больных метастатическим раком толстой кишки (мРТК) расширились за счет появления таргетных препаратов, большинство из которых обладают антиангиогенным действием (бевацизумаб, афлиберцепт, рамуцирумаб, регорафениб). Одним из вариантов стандартной терапии больных в 1-й линии является комбинация химиопрепаратов и бевацизумаба, особенно у лиц с мутацией в генах EGFR-сигнального пути. Однако у большинства пациентов рано или поздно разовьется прогрессирование, и нельзя однозначно сказать, что следует назначать больному во 2-й линии лечения. Именно сложности выбора последовательности терапии у лиц с мРТК в случае назначения антиангиогенных препаратов в 1-й линии терапии и посвящен настоящий обзор.

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