ПРЕДИКТИВНЫЕ МАРКЕРЫ ОТВЕТА НА БЛОКАТОРЫ КОНТРОЛЬНЫХ ТОЧЕК ИММУННОГО ОТВЕТА

Despite the unprecedented success in using immune checkpoint inhibitors in the treatment of lung cancer, melanoma, hypermutable tumors of various localization, etc., a significant proportion of patients receiving these drugs do not respond to treatment. Predictive markers routinely used in the selection of patients for immunotherapy, in particular, the level of expression of PD -L1 and the presence of microsatellite instability, have certain limitations. Over the past decade, many other biomarkers designed to predict response to immunotherapy have been proposed, namely: tymor mutation burden, composition of lymphocytic infiltrate; allelic composition of the major histocompatibility complex; relationship between the numbers of different formed elements of blood as well as between its biochemical parameters; microflora of the digestive tract, etc. These markers can directly or indirectly reflect the immunogenicity of the tumor itself, as well as the state of systemic and intratumoral immune response. The predictive power and reliability of these markers are extremely different. When preparing this review, we conducted a literature search for recent studies regarding predictors of efficacy for immune checkpoint inhibitors published in the journals included in the databases, such as Pubmed, Web of Science, and Scopus.Несмотря на беспрецедентный успех применения ингибиторов контрольных точек иммунного ответа в терапии рака легкого, меланомы, гипермутабельных новообразований различной локализации и проч., существенная доля пациентов, получающих препараты этой группы, не демонстрирует ответа на лечение. Предиктивные маркеры, рутинно используемые при отборе больных для прохождения иммунотерапии, в частности уровень экспрессии PD -L1 и наличие микросателлитной нестабильности, имеют определённые ограничения. За последнее десятилетие было предложено множество иных биомаркеров, призванных предсказать эффект на назначение иммунотерапии: внутриопухолевая мутационная нагрузка, состав лимфоцитарного инфильтрата; аллельная композиция главного комплекса гистосовместимости; соотношения между количеством различных форменных элементов крови и ее биохимическими показателями; особенности микрофлоры ЖКТ и т. д. Эти маркеры могут прямо или косвенно отражать иммуногенность самой опухоли, а также состояние системного и внутриопухолевого иммунитета. Предсказательная сила, достоверность и степень их близости к практическому применению чрезвычайно различны. При подготовке данного обзора был проведен поиск литературы последних лет, касающейся изучения предикторов эффективности ингибиторов контрольных точек иммунного ответа, в журналах, входящих в базы данных Pubmed, Web of Science, Scopus

КЛИНИКО-МОРФОЛОГИЧЕСКИЕ ОСОБЕННОСТИ НАСЛЕДСТВЕННОГО РАКА ЯИЧНИКА

Germ-line mutations in BRCA1 and BRCA2 genes are the most established risk factors for hereditary breast and ovarian cancers. The purpose of the study was to analyze BRCA1/2 testing in ovarian cancer patients. Materials and methods. We analyzed 222 patients with ovarian cancer (OC) who underwent genetic testing. Results. Recurrent Slavic mutations in these genes were detected in 60/222 (27%) patients.104 patients lacked any clinical signs of hereditary form of the disease, however BRCA1/2 genetic defects were identified among 11 (11%) of these women. BRCA1/2-associated carcinomas were characterized by more advanced stage at diagnosis and predominance of high-grade serous histological tumor subtype. Conclusion. These results emphasize the need for BRCA1/2 testing for all patients with OC. BRCA1/2-associated carcinomas have clinical and pathological cgaracteristics, which should be considered while planning therapy. Наследственные мутации в генах BRCA1 и BRCA2 являются наиболее известными и изученными факторами риска карцином молочной железы и яичника. Цель исследования – анализ опыта BRCA1/2- тестирования больных раком яичника. Материал и методы. Проанализированы данные 222 больных раком яичника (РЯ), направленных на генетическое тестирование. Результаты. Генетический дефект в генах BRCA1/2 был выявлен у 60 (27 %) из 222 пациенток. В группе женщин без клинических признаков наследственной формы заболевания генетические дефекты BRCA1/2 были обнаружены у 11 (11 %) из 104 пациенток. BRCA1/2-ассоциированные карциномы характеризовались более поздней стадией заболевания и преобладанием низкодифференцированного серозного гистологического типа опухоли. Заключение. BRCA1/2-ассоциированные опухоли составляют значимую часть злокачественных новообразований яичника, что обусловливает целесообразность генетического тестирования для всех пациенток с РЯ. BRCA1/2-ассоциированные карциномы имеют клинические и морфологические особенности, которые необходимо учитывать при планировании терапии.

Human placental extract: A human placental extract: in vivo and in vitro assessments of its melanocyte growth and pigment-inducing activities

The authenticity of various prototype human placental extracts with biological activity, such as that inducing vitiligo repigmentation, is under serious criticism, mainly due to a lack of demonstration at the cellular level. Considering the present worldwide scenario with regard to the occurrence and treatment of vitiligo, a thorough scientific exploration of such extracts should be undertaken. One such prototype placental preparation was prepared, and was evaluated with regard to its melanogenic action in C57BL/6J mice in vivo and its mitogenic and melanogenic activity on B16F10 mouse melanoma cells and normal human melanocytes in vitro. The extract was applied topically to mice with age-induced prolonged telogenic phase of hair growth (grey body coat hair). Standard 3H-thymidine incorporation and spectrophotometric methods were followed to illustrate mitogenic and melanogenic effects at the cellular level. The resurgence of blue skin, followed by shiny black hair, at the regions of application of the extract demonstrated the reversal of the age-induced prolonged telogenic phase of hair growth to the anagenic phase after topical application of the extract on C57BL/6J mice. Further support was obtained from histology where, at the extract-treated sites, the development of new melanogenic centers and hair follicles was observed. During in vitro studies, the vehicle-free extract constituents stimulated both mitogenesis and melanogenesis of B16F10 mouse melanoma cells in a concentration-dependent manner. The cell morphology and extent of melanogenesis also showed significant changes. In addition, two known melanocyte activitymodulating peptides, endothelin-1 (ET-1) and adrenocorticotropic hormone (ACTH), were determined in the extract, chiefly in the total lipid fraction, indicating their effective cutaneous permeation. The extract was found to be a potent mitogen in the in vitro condition and a potent melanogen in both the in vitro and in vivo situations. This strongly suggests its therapeutic potential for the repigmentation of vitiligo patches

CLINICAL AND MORPHOLOGICAL FEATURES OF HEREDITARY OVARIAN CANCER

Germ-line mutations in BRCA1 and BRCA2 genes are the most established risk factors for hereditary breast and ovarian cancers. The purpose of the study was to analyze BRCA1/2 testing in ovarian cancer patients. Materials and methods. We analyzed 222 patients with ovarian cancer (OC) who underwent genetic testing. Results. Recurrent Slavic mutations in these genes were detected in 60/222 (27%) patients.104 patients lacked any clinical signs of hereditary form of the disease, however BRCA1/2 genetic defects were identified among 11 (11%) of these women. BRCA1/2-associated carcinomas were characterized by more advanced stage at diagnosis and predominance of high-grade serous histological tumor subtype. Conclusion. These results emphasize the need for BRCA1/2 testing for all patients with OC. BRCA1/2-associated carcinomas have clinical and pathological cgaracteristics, which should be considered while planning therapy