Значение циркулирующей опухолевой ДНК в оценке эффективности лечения метастатического колоректального рака

Автор: Служев Максим Иванович, Семиглазов Владислав Владимирович, Семиглазова Татьяна Юрьевна, Ткаченко Елена Викторовна, Проценко Ветлана Анатольевна, Латипова Дилором Хамидовна, Кондратьев Сергей Вальерьевич, Бриш Надежда Александровна, Алексеева Юлия Владимировна, Беляев Алексей Михайлович

Журнал: Сибирский онкологический журнал @siboncoj

Рубрика: Обзоры

Статья в выпуске: 5 т.20, 2021 года.

Бесплатный доступ

Проблемы диагностики, мониторинга эффективности лечения и прогноза при ряде диссеминированных злокачественных опухолей в настоящее время решаются путем определения циркулирующих опухолевых ДНК (цДНК). Особое значение оценка данного маркера приобрела при метастатическом колоректальном раке, системное лечение которого зависит от статуса гена RAS, имеющего прогностическую и предиктивную ценность. Однако возможности забора материала из первичного или метастатического очага для патоморфологического и молекулярного анализа при колоректальном раке зачастую ограничены. В такой ситуации определение цДНК с помощью жидкостной биопсии имеет преимущество по сравнению со стандартной биопсией ввиду малой инвазивности и высокой доступности метода. Анализ мутаций с помощью цДНК и изменения уровня данного маркера позволяет определить показания к адъювантному лечению раннего колоректального рака, является критерием эффективности системного лечения, а также фактором, определяющим риск прогрессирования заболевания. В настоящее время изучается потенциальная возможность использования цДНК для мониторинга эффективности химиотерапии в 1-й и 2-й линиях лечения, а также прогнозирования развития вторичной резистентности к ингибиторам EGFR (цетуксимаб и панитумумаб) в 1-й линии лечения и оценки статуса RAS для возращения к терапии ингибиторами EGFR в 3-й линии лечения метастатического колоректального рака. В ряде пилотных исследований получены данные, касающиеся эффективности повторной терапии ингибиторами EGFR. Выполнен анализ современных литературных данных, опубликованных в ведущих рецензируемых журналах в российских и международных базах научного цитирования Medline, Elibrary, PubMed. Из 138 проанализированных источников 56 были использованы для подготовки настоящего обзора.

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Метастатический колоректальный рак, циркулирующие опухолевые днк, мутации ras, ингибиторы egfr

Короткий адрес: https://sciup.org/140261332

IDR: 140261332 | DOI: 10.21294/1814-4861-2021-20-5-149-161

Список литературы Значение циркулирующей опухолевой ДНК в оценке эффективности лечения метастатического колоректального рака

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