tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2019-9-4-70-74tumors-696Research ArticleМНЕНИЕ ЭКСПЕРТАEXPERT OPINIONПериоперационное использование анти-EGFR-антител при операбельных и потенциально операбельных метастазах колоректального рака в печень. Оправдывает ли повышение резектабельности возможные риски?Perioperative use of anti-EGFR antibodies in resectable and potentially resectable liver metastasesЖуковН. В.ZhukovN.  V.

Николай В. Жуков, д. м. н., руководитель отдела междисциплинарной онкологии; доцент кафедры онкологии, гематологии и лучевой терапии

Москва

Nikolay V. Zhukov, MD, PhD, DSc, Head of the Department of Interdisciplinary Oncology; Associate Professor, Department of Oncology, Hematology and Radiation Therapy

Moscow

ФГБУ «НМИЦ детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России; ФГБОУ ВО «Российский национальный исследовательский медицинский центр им. Н.И. Пирогова» Минздрава РоссииРоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; N. I. Pirogov Russian National Research Medical UniversityRussian Federation201927032020947074Copyright © Жуков Н.В., 20202020Жуков Н.В.Zhukov N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/696

Радикальное удаление всех видимых проявлений заболевания позволяет значимо улучшить прогноз больных метастатическим колоректальным раком, однако тотальная метастазэктомия изначально возможна лишь у небольшой доли больных, при этом у многих из них в дальнейшем развивается рецидив. С целью увеличения числа больных, подлежащих радикальному вмешательству, и снижения риска последующего рецидива в рутинной практике широко используется предоперационная химиотерапия (с или без последующего адъювантного лечения). В надежде на улучшение непосредственной эффективности (увеличение частоты R0 резекции) и отдаленных результатов лечения предоперационную химиотерапию зачастую дополняют биологическими агентами (анти-EGFR и анти-VEGF моноклональными антителами), в ряде случаев продолжая их использование и после операции (периоперационная терапия). Однако, несмотря на имеющиеся доказательства увеличения резектабельности, полноценная информация о влиянии такого подхода на отдаленные результаты лечения до настоящего времени отсутствовала. Анализ последних исследований в данной области ставит под сомнение безопасность периоперационного использования анти-EGFR антител у больных с потенциально излечимым метастатическим колоректальном раком.

The radical resection of all visible disease manifestations can significantly improve the prognosis of patients with metastatic colorectal cancer, however, complete metastasectomy is initially possible only in a small proportion of patients, with many of them subsequently developing relapse. Aiming to increase the number of patients subject to radical intervention and to reduce the recurrence risk, preoperative chemotherapy (with or without subsequent adjuvant treatment) is widely used in routine practice. In the hope of increasing immediate effectiveness (increasing the proportion of patients subject to R0 resection) and the long-term results of treatment, preoperative chemotherapy is often accompanied with biological agents (anti-EGFR and anti-VEGF monoclonal antibodies) continued after surgery in some cases. However, despite the evidence of increased resectability, the impact of this approach on long-term treatment outcomes has not yet been determined. The analysis of recent studies in this area doubts the safety of perioperative use of anti-EGFR antibodies in patients with potentially curable metastatic colorectal cancer.

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The authors declare that there are no conflicts of interest present.