vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2023.4.TX.4vmireaviz-823Research ArticleДонорство и трансплантация органов и тканейOrgan and tissue donation and transplantationИммунотерапия гепатоцеллюлярной карциномы у пациентов, перенёсших пересадку печени (обзор литературы)Immunotherapy for hepatocellular carcinoma in liver transplant patients (Literature review)https://orcid.org/0000-0002-6323-511XДжанянИ. А.DzhanyanI. A.

Джанян Ирина Анатольевна - Врач-онколог отделения противоопухолевой лекарственной терапии № 3 отдела лекарственного лечения.

Каширское шоссе, д. 24, Москва, 115478

Irina A. Dzhanyan - Oncologist of of Department of Antitumor Drug Therapy No. 3 (Department of Drug Treatment).

24 Kashirskoe shosse, Moscow, 115478

i-dzhanyan@mail.ruhttps://orcid.org/0000-0002-6362-7914НоврузбековМ. С.NovruzbekovM. S.

Новрузбеков Мурад Сафтарович - доктор медицинских наук, профессор, заведующий отделением трансплантации печени.

Большая Сухаревская площадь, д. 3, Москва, 129090

Murad S. Novruzbekov - Dr. Sci. (Med.), Chief of Liver transplantation Department.

3 Bolshaya Sukharevskaya Square, Moscow, 129090

N.m.s@bk.ruhttps://orcid.org/0000-0002-0691-5581ОлисовО. Д.OlisovO. D.

Олисов Олег Даниелович - кандидат медицинских наук, старший научный сотрудник отделения трансплантации печени.

Большая Сухаревская площадь, д. 3, Москва, 129090

Oleg D. Olisov - Cand. Sci. (Med.), Associate Senior Research Liver transplant Department.

3 Bolshaya Sukharevskaya Square, Moscow, 129090

Dr.Olisov@gmail.comhttps://orcid.org/0000-0002-0620-2696ЮдинД. И.YudinD. I.

Юдин Денис Иванович - кандидат медицинских наук, старший научный сотрудник отделения противоопухолевой лекарственной терапии № 3 отдела лекарственного лечения.

Каширское шоссе, д. 24, Москва, 115478

Denis I. Yudin - Cand. Sci. (Med.), Associate Senior Research of Department of Antitumor Drug Therapy No. 3 (Department of Drug Treatment).

24 Kashirskoe shosse, Moscow, 115478

yudinden@mail.ruhttps://orcid.org/0000-0002-3171-6621РудаковВ. С.RudakovV. S.

Рудаков Владимир Сергеевич - кандидат медицинских наук, врач-хирург центра хирургии и трансплантации.

Ул. Маршала Новикова, д. 23, Москва, 123098

Vladimir S. Rudakov - Cand. Sci. (Med.), surgeon of the Center for Surgery and Transplantology.

23 Marshal Novikov str., Moscow, 123098

Rudakov_vc@list.ruhttps://orcid.org/0000-0002-9740-3839АнтоноваЕ. Ю.AntonovaE. Yu.

Антонова Елена Юрьевна - врач-онколог отделения противоопухолевой лекарственной терапии № 3 отдела лекарственного лечения.

Каширское шоссе, д. 24, Москва, 115478

Elena Yu. Antonova - Oncologist of Department of Antitumor Drug Therapy No. 3 (Department of Drug Treatment).

24 Kashirskoe shosse, Moscow, 115478

elenaantonova5@mail.ruhttps://orcid.org/0000-0003-2142-661XСавченкоИ. В.SavchenkoI. V.

Савченко Илья Вячеславович - врач-онколог отделения противоопухолевой лекарственной терапии № 3 отдела лекарственного лечения.

Каширское шоссе, д. 24, Москва, 115478

Ilya V. Savchenko - Oncologist of Department of Antitumor Drug Therapy No. 3 (Department of Drug Treatment).

24 Kashirskoe shosse, Moscow, 115478

sv2505.is2006@gmail.comhttps://orcid.org/0000-0002-4587-4153ПогребняковИ. В.PogrebnyakovI. V.

Погребняков Игорь Владимирович - кандидат медицинских наук, заведующий отделением рентгенохирургических методов диагностики и лечения.

Каширское шоссе, д. 24, Москва, 115478

Igor V. Pogrebnyakov - Cand. Sci. (Med.), Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment.

24 Kashirskoe shosse, Moscow, 115478

i.pogr@mail.ruhttps://orcid.org/0000-0002-6244-4294БредерВ. В.BrederV. V.

Владимирович Бредер Валерий - Доктор медицинских наук, заведующий отделом лекарственных методов лечения.

Каширское шоссе, д. 24, Москва, 115478

Valery V. Breder - Dr. Sci. (Med.), head of the department of medicinal treatment.

24 Kashirskoe shosse, Moscow, 115478

vbreder@yandex.ruhttps://orcid.org/0000-0002-5183-1555ПиткевичМ. Ю.PitkevichM. Yu.

Питкевич Мария Юрьевна - врач-радиолог.

Госпитальная пл., д. 3, Москва, 105094

Mariya Yu. Pitkevich – Radiologist.

3 Hospital Square, Moscow, 105094

m.u.pitkevich@gmail.comНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency MedicineRussian FederationФедеральный медицинский биофизический центр им. А.И. БурназянаРоссияA.I. Burnazyan Federal Medical Biophysical CenterRussian FederationГлавный военный клинический госпиталь им. академика Н.Н. БурденкоРоссияMain Military Clinical Hospital named after Academician N.N. BurdenkoRussian Federation202312092023134162168Copyright © Джанян И.А., Новрузбеков М.С., Олисов О.Д., Юдин Д.И., Рудаков В.С., Антонова Е.Ю., Савченко И.В., Погребняков И.В., Бредер В.В., Питкевич М.Ю., 20232023Джанян И.А., Новрузбеков М.С., Олисов О.Д., Юдин Д.И., Рудаков В.С., Антонова Е.Ю., Савченко И.В., Погребняков И.В., Бредер В.В., Питкевич М.Ю.Dzhanyan I.A., Novruzbekov M.S., Olisov O.D., Yudin D.I., Rudakov V.S., Antonova E.Y., Savchenko I.V., Pogrebnyakov I.V., Breder V.V., Pitkevich M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/823

Гепатоцеллюлярная карцинома (ГЦК) - третья причина смертности от рака во всем мире, на которую приходится более 800 000 смертей ежегодно. Хирургическое удаление новообразования остаётся наиболее эффективным вариантом лечения. Частичная резекция печени является адекватным решением для пациентов без цирроза или с хорошо компенсированным циррозом, ортотопическая трансплантация печени необходима у пациентов с ранней стадией ГЦК на фоне цирроза. Рецидив опухоли остаётся основным ограничением долгосрочной выживаемости пациентов после трансплантации печени. Посттрансплантационная иммуносупрессия снижает противоопухолевую защиту организма, которая обеспечивается естественным иммунитетом. Это способствует развитию и прогрессированию опухолевого процесса. Цель исследования: проанализировать отечественные и зарубежные публикации, в которых представлены варианты лечения рецидива ГЦК после трансплантации печени. Проведён поиск литературных источников в базах данных PubMed, Scopus, Web of Science, MEDLINE, eLibrary. Поиск проводили на русском и английском языках, по ключевым словам: гепатоцеллюлярная карцинома, ингибиторы терозинкиназы, ингибиторы иммунных контрольных точек, терапия рецидива ГЦК, ортотопическая трансплантация печени, индекс RETREAT, регорафениб, ниволумаб. Авторами представлен обзор данных о применении ингибиторов терозинкиназы и ингибиторов иммунных контрольных точек для предотвращения рецидива ГЦК. Результаты анализа источников литературы показали, что вопрос посттрансплантационной иммуносупрессии является актуальным. Большое количество исследований и разборов клинических случаев оставляет надежду, что в скором времени будет найден эффективный способ проведения иммуносупрессии для рецидивирующих пациентов с ГЦК после пересадки печени.

Hepatocellular carcinoma (HCC) is the third cause of cancer-related mortality worldwide, accounting for more than 800,000 deaths annually. Surgical removal of the neoplasm remains the most effective treatment option. Partial liver resection is an adequate solution for patients without cirrhosis or with well-compensated cirrhosis, orthotopic liver transplantation is necessary in patients with early stage HCC on the background of cirrhosis. Tumor recurrence remains a major limitation of long-term survival of patients after liver transplantation. Posttransplant immunosuppression reduces the body's antitumor defense, which is provided by natural immunity. This contributes to the development and progression of the tumor process. Purpose of the study: to analyze domestic and foreign publications that present treatment options for HCC recurrence after liver transplantation. Literature sources were searched in PubMed, Scopus, Web of Science, MEDLINE, eLibrary databases. The search was conducted in Russian and English by keywords: hepatocellular carcinoma, tyrosine kinase inhibitors, immune checkpoint inhibitors, therapy of HCC relapse, orthotopic liver transplantation, RETREAT index, regorafenib, nivolumab. The authors presented a review of the data on the use of tyrosine kinase inhibitors and immune checkpoint inhibitors to prevent HCC recurrence. The results of the analysis of literature sources showed that the issue of post-transplant immunosuppression is relevant. The large number of studies and clinical case reviews leaves hope that an effective way of immunosuppression for recurrent HCC patients after liver transplantation will soon be found.

гепатоцеллюлярная карциномаингибиторы терозинкиназыингибиторы иммунных контрольных точектерапия рецидива гепатоцеллюлярной карциномыортотопическая трансплантация печенииндекс RETREATрегорафенибниволумабhepatocellular carcinomatyrosine kinase inhibitorsimmune checkpoint inhibitorstherapy for recurrent hepatocellular carcinomaorthotopic liver transplantationRETREAT indexregorafenibnivolumabИсследование проводилось без спонсорской поддержкиThis research received no external fundingReferencesWhite DL, Thrift AP, Kanwal F, Davila J, El-Serag HB. Incidence of Hepatocellular Carcinoma in All 50 United States, From 2000 Through 2012. Gastroenterology. 2017;152(4):812-820.e5. URL: https://www.gastrojournal.org/article/S0016-5085(16)35389-6/fulltextWhite DL, Thrift AP, Kanwal F, Davila J, El-Serag HB. Incidence of Hepatocellular Carcinoma in All 50 United States, From 2000 Through 2012. Gastroenterology. 2017;152(4):812-820.e5. 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The authors declare that there are no conflicts of interest present.