Первичная резистентность к анти-HER2-терапии: механизмы развития и пути преодоления
Рак молочной железы (РМЖ) является самой распространенной опухолевой локализацией у женщин. Опухоли с положительным рецептором эпидермального фактора роста человека второго типа (HER2) составляют около 25–30% всех подтипов РМЖ и коррелируют с неблагоприятным прогнозом. Уже на протяжении многих лет трастузумаб, моноклональное антитело, используется для ингибирования активности HER2. Введение в клиническую практику данного препарата совершило настоящую революцию в мире лечения HER2 позитивного РМЖ. Однако на сегодняшний день встречаются случаи первичной резистентности к анти-HER2-терапии. В связи с этим определение механизмов резистентности и исследование новых терапевтических агентов могут приводить к разработке более эффективной блокады передачи сигналов рецепторами семейства HER. За последние несколько лет изучено множество механизмов резистентности, регулярно совершаются попытки внедрения новых терапевтических препаратов для лечения пациентов с резистентностью к трастузумаб-содержащей терапии, но должной эффективности на сегодняшний день достигнуто не было. В связи с этим целью данной статьи являются обзор механизмов резистентности к анти-HER2-терапии и способов ее преодоления, а также демонстрация клинического опыта ведения пациентки с подобным состоянием.Дашян Г.А., Джелялов Э.С., Константинова В.В., Гронская Ю.А., Мурских А.Д., Ахмедов Р.М., Тюсенко А.Е., Олчонова А.А., Дьяконенко З.В., Середа О.А., Белоусов А.М.
Ключевые слова
рак молочной железы
трастузумаб
лапатиниб
резистентность
анти-HER2-терапия
трастузумаб-эмтанзин
T-DM1
нелюминальный тип
HER2-позитивный тип
HER2 гетерогенность
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Об авторах / Для корреспонденции
Автор для связи: Гарик Альбертович Дашян, д.м.н., зав. онкологическим отделением № 1 (хирургических методов лечения опухолей молочной железы, кожи и мягких тканей) Клиники высоких медицинских технологий им. Н.И. Пирогова, Санкт-Петербургский государственный университет, Санкт-Петербург, Россия; dgarik@mail.ru
ORCID / Scopus Author ID / SPIN-код:
Г.А. Дашян (Dashyan G.A.), https://orcid.org/0000-0001-6183-9764; Scopus Author ID: 17344871400; SPIN-код: 6989-7148
Э.С. Джелялов (Dzhelialov E.S.), https://orcid.org/0000-0002-2571-243X; SPIN-код: 7261-2325
В.В. Константинова (Konstantinova V.V.), https://orcid.org/0000-0001-9650-7305
Ю.А. Гронская (Gronskaya Yu.A.), https://orcid.org/0000-0002-1060-0806
А.Д. Мурских (Murskikh A.D.), https://orcid.org/0009-0006-1825-6196; SPIN-код: 5837-5887
Р.М. Ахмедов (Akhmedov R.M.), https://orcid.org/0000-0003-3348-4251
А.Е. Тюсенко (Tyusenko A.E.), https://orcid.org/0000-0003-0689-6058; SPIN-код: 9223-5741
А.А. Олчонова (Olchonova A.A.), https://orcid.org/0009-007-3112-8081
З.В. Дьяконенко (Dyakonenko Z.V.), https://orcid.org/0009-0003-1287-8048; SPIN-код: 7767-1149
О.А. Середа (Sereda O.A.), https://orcid.org/0000-0001-7553-2026
А.М. Белоусов (Belousov A.M.), https://orcid.org/0000-0002-2274-8170
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