Биомаркеры для иммунотерапии немелкоклеточного рака легкого

Открытие ингибирования иммунных контрольных точек произвело революцию в лечении многих солидных злокачественных новообразований, включая немелкоклеточный рак легкого (НМРЛ). Ингибиторы иммунных контрольных точек (ИИКТ) обладают способностью восстанавливать противоопухолевый иммунный ответ, блокируя торможение активации Т-лимфоцитов. Anti-programmed death-ligand 1, трансмембранный белок, лиганд к рецептору PD-1(PD-L1) в настоящее время является основным биомаркером эффективности анти-PD-1/ PD-L1 препаратов лечении НМРЛ без драйверных мутаций. Высокая мутационная нагрузка опухоли, предполагающая повышенную продукцию неоантигенов, также ассоциируется с эффективностью иммунотерапии. Микросателлитная нестабильность – другой биомаркер, одобренный для иммунотерапии при солидных опухолях, – редко наблюдается при НМРЛ. Первичная резистентность к ИИКТ характерна для онкодрайверного НМРЛ, приобретенная связана с иммуноредактированием в результате истощения потенциально иммуногенных неоантигенов. В обзоре обсуждаются последние достижения и будущие направления прогнозирования результатов иммунотерапии у больных НМРЛ.

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