Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya8304010.26442/18151434.2021.3.201189CLINICAL ONCOLOGYКЛИНИЧЕСКАЯ ОНКОЛОГИЯReview ArticleDual immunological blockade in the treatment of metastatic non-small cell lung cancer: reality and perspectivesМесто двойной иммунологической блокады в лечении метастатического немелкоклеточного рака легкого: реальность и перспективыhttps://orcid.org/0000-0002-0620-2696YudinDenis I.ЮдинДенис Иванович
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, ст. науч. сотр. отд-ния лекарственных методов лечения (химиотерапевтическое) №17

yudinden@mail.ruhttps://orcid.org/0000-0003-4469-502XLaktionovKonstantin K.ЛактионовКонстантин Константинович
Russian Federation

D. Sci. (Med.), Prof.

д-р мед. наук, проф. каф. онкологии и лучевой терапии лечебного фак-та, зав. онкологическим отд-нием лекарственных методов лечения (химиотерапевтическое) №17

lkoskos@mail.ruhttps://orcid.org/0000-0002-5749-9864LaktionovaLiudmila V.ЛактионоваЛюдмила Валентиновна
Russian Federation

D. Sci. (Med.)

д-р мед. наук

laktionova@list.ruhttps://orcid.org/0000-0002-6244-4294BrederValeriy V.БредерВалерий Владимирович
Russian Federation

D. Sci. (Med.)

д-р мед. наук, вед. науч. сотр.

vbreder@yandex.ruBlokhin National Medical Research Center of OncologyФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииPirogov Russian National Research Medical UniversityФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииMedical Center on KolomenskayaЗАО «МЦК»1911202123342843512102021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/83040

Nowadays immunotherapy is a crucial option in the treatment of non-small cell lung cancer. There are a lot of actual options of the first-line therapy for the patients with metastatic lung cancer, including dual immunological blockade of PD-1/PD-L1 and CTLA-4 pathways. This review is an attempt to clarify the place of dual immunological blockade now and in the future. The scientific rationale for dual immunotherapy is a possible synergy and overcome resistance to single-drug therapy. The review collected information from open sources, both current studies with dual immunological blockade, and already obtained results of the trials for nivolumab and ipilimumab, tremelimumab and durvalumab, and other combinations for the treatment of patients with metastatic non-small cell lung cancer. This approach is promising for the possible overcoming of resistance to monoimmunotherapy with anti-PD1/PD-L1 antibodies, especially in the population with low and negative PD-L1 status.

В настоящее время иммунотерапия является ключевой опцией в лекарственном лечении немелкоклеточного рака легкого. Перед онкологами в реальной клинической практике стоит непростой выбор 1-й линии терапии от моноиммунотерапии до различных комбинированных режимов, включая двойную иммунологическую блокаду PD-1/PD-L1 и CTLA-4. Цель данного обзора – попытка уточнить место двойной иммунологической блокады среди других режимов комбинированного лечения немелкоклеточного рака легкого в настоящее время и возможные перспективы. Позитивные ожидания от двойной иммунотерапии связаны с предположением, что комбинированное использование этих препаратов является синергетическим и может помочь преодолеть резистентность к терапии одним препаратом. В обзоре собрана информация из открытых источников как о текущих исследованиях с двойной иммунологической блокадой, так и о уже полученных результатах по применению комбинации ниволумаба и ипилимумаба, тремелимумаба и дурвалумаба и других препаратов для лечения пациентов с метастатическим немелкоклеточным раком легкого. Использование данного подхода представляется перспективным для возможного преодоления резистентности к моноиммунотерапии анти-PD1/PD-L1-препаратами, особенно в популяции пациентов с низким и негативным PD-L1-статусом.

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