РАК ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ. НЕКОТОРЫЕ МОЛЕКУЛЯРНЫЕ И ГЕНЕТИЧЕСКИЕ МЕХАНИЗМЫ ОНКОГЕНЕЗА КАК МИШЕНЬ ДЛЯ ТЕРАПИИ

РПЖ (РПЖ) является одним из самых опасных и клинически сложных видов рака. Отсутствие эффективных методов скрининга, поздняя выявляемость являются основными причинами того, что РПЖ остается одним из заболеваний, при котором уровень смертности практически равен уровню заболеваемости. При этом хирургические и терапевтические методы лечения остаются малоэффективными. Использование различных видов химиотерапии увеличивает продолжительность жизни больных с 5-7 месяцев при лечении одним гемцитабином до 8,5-11 месяцев при комбинированной терапии. Поэтому поиск новых мишеней для терапии является ключевой задачей при данной патологии. В обзорной статье представлены результаты последних исследований в области генетики и молекулярной биологии РПЖ. Описаны мутации основных генов: KRAS, TP53, CDKN 2A, SMAD 4, ARID 1A и также часто выявляемые дефекты других генов: TGFBR 2, KDM6A, AXIN 1, ACVR 1B, PIK3CA, RNF43, GNAS, ATM, GLI3, ARID 1A и RBM10. Представлены результаты анализа связи мутаций этих генов с изменениями индуцируемых ими сигнальных путей и освещены возможности использования найденных особенностей в качестве мишеней для таргетной терапии РПЖ. В обзоре отражены проблемы изменения иммунного статуса, механизмы участия клеточного компонента стромы в процессах опухолевой прогрессии и метастазирования, возможности использования специфических антител в комбинированных схемах химиотерапии при РПЖ.

РПЖ, гены, молекулярные пути, таргетная терапия, иммунотерапия

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