surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2023-13-2-131-142surgonco-810Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSАтезолизумаб и бевацизумаб у пациентов с гепатоцеллюлярной карциномой в реальной клинической практикеAtezolizumab and Bevacizumab in Therapy for Patients with Hepatocellular Carcinoma in Real Clinical Practicehttps://orcid.org/0000-0002-7082-0085СеребренниковГ. А.SerebrennikovG. A.

Григорий Андреевич Серебренников

отделение противоопухолевой лекарственной терапии № 2

Республика Башкортостан

Уфа

Grigoriy A. Serebrennikov

Antiсancer Drug Therapy Unit No. 2

Ufa

https://orcid.org/0000-0003-3734-2779МеньшиковК. В.MenshikovК. V.

Константин Викторович Меньшиков, к. м. н., доцент

отдел химиотерапии

ИДПО

кафедра онкологии с курсами онкологии и патологической анатомии

Республика Башкортостан

Уфа

Кonstantin V. Menshikov, Cand. Sci. (Med.), Assoc. Prof.

Chemotherapy Unit

Department of Oncology with Courses of Oncology andPathological Anatomy for Advanced Professional Education

Ufa

kmenshikov80@bk.ruhttps://orcid.org/0000-0003-0996-5995СултанбаевА. В.SultanbaevA. V.

Александр Валерьевич Султанбаев, к. м. н.

отдел противоопухолевой лекарственной терапии

Республика Башкортостан

Уфа

Alexander V. Sultanbaev, Cand. Sci. (Med.)

Anticancer Drug Therapy Unit

Ufa

https://orcid.org/0000-0003-1185-977XМусинШ. И.MusinSh. I.

Шамиль Исмагилович Мусин, к. м. н.

хирургическое отделение № 6

Республика Башкортостан

Уфа

Shamil I. Musin, Cand. Sci. (Med.)

Surgery Unit No. 6

Ufa

https://orcid.org/0000-0002-8665-8895МеньшиковаИ. А.MenshikovaI. A.

Ирина Асхатовна Меньшикова, к. м. н., доцент

кафедра биологической химии

Республика Башкортостан

Уфа

Irina A. Menshikova, Cand. Sci. (Med.), Assoc. Prof.

Department of Biological Chemistry

Ufa

https://orcid.org/0000-0001-5926-0446СултанбаеваН. И.SultanbaevaN. I.

Надежда Ивановна Султанбаева

отделение противоопухолевой лекарственной терапии № 1

Республика Башкортостан

Уфа

Nadezhda I. Sultanbaeva

Anticancer Drug Therapy Unit No. 1

Ufa

https://orcid.org/0000-0002-3193-9008ЛипатовД. О.LipatovD. O.

Данила Олегович Липатов, студент

лечебный факультет

Республика Башкортостан

Уфа

Danila O. Lipatov, Student

Ufa

РезяповаА. Ш.RezyapovaA. Sh.

Азалия Шамилевна Резяпова, студент

лечебный факультет

Республика Башкортостан

Уфа

Azaliya Sh. Rezyapova, Student

Ufa

Республиканский клинический онкологический диспансерРоссияRepublican Clinical Oncology DispensaryRussian FederationРеспубликанский клинический онкологический диспансер; Башкирский государственный медицинский университетРоссияRepublican Clinical Oncology Dispensary; Bashkir State Medical UniversityRussian FederationБашкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation202330062023132131142Copyright © Серебренников Г.А., Меньшиков К.В., Султанбаев А.В., Мусин Ш.И., Меньшикова И.А., Султанбаева Н.И., Липатов Д.О., Резяпова А.Ш., 20232023Серебренников Г.А., Меньшиков К.В., Султанбаев А.В., Мусин Ш.И., Меньшикова И.А., Султанбаева Н.И., Липатов Д.О., Резяпова А.Ш.Serebrennikov G.A., Menshikov К.V., Sultanbaev A.V., Musin S.I., Menshikova I.A., Sultanbaeva N.I., Lipatov D.O., Rezyapova A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/810

   Рандомизированные клинические исследования и реальная клиническая практика имеют много различий. Создание новых лекарственных средств во время доказательной медицины основано прежде всего на фармацевтических разработках, проведении доклинических исследований и, самое основное, рандомизированных клинических исследованиях. Гепатоцеллюлярная карцинома является наиболее распространенной первичной злокачественной опухолью печени и одной из ведущих причин смертности среди онкологических пациентов во всем мире с примерным количеством 800 000 смертей ежегодно. Более 10 лет тирозинкиназный ингибитор сорафениб был единственным зарегистрированным средством лечения распространенной гепатоцеллюлярной карциномы. Следующим этапом развития лекарственной терапии гепатоцеллюлярной карциномы явилась терапия ингибиторами контрольных точек иммунитета. Комбинация атезолизумаба с бевацизумабом в исследовании III фазы (IMbrave150) улучшила результаты лечения распространенной гепатоцеллюлярной карциномы, такие как общая выживаемость и выживаемость без прогрессирования (6,8 против 4,3). Приведенные в статье исследования комбинации атезолизумаба и бевацизумаба демонстрируют сопоставимые данные при лечении пациентов с ГЦК в реальной клинической практике и в исследовании III фазы IMbrave150. Проспективные клинические испытания, которые включают разнородные группы пациентов, необходимы для дальнейшего анализа эффективности комбинации атезолизумаба и бевацизумаба.

   Randomized clinical trials and actual clinical practice differsignificantly. Evidence-based medicine develops new agents referring to, primarily, pharmaceutical findings, preclinical studies and, most importantly, randomized clinical trials. Hepatocellular carcinoma is the most common primary malignancy of the liver, and one of the main causes of fatal outcomes among cancer patients worldwide, including in the Asia-Pacific region, with an estimated 800,000 deaths annually. For more than 10 years, sorafenib, a tyrosine kinase inhibitor, was the only authorized treatment for advanced hepatocellular carcinoma. The next stage in the development of drug therapy for hepatocellular carcinoma involved immune checkpoint inhibitors. The combination of atezolizumab with bevacizumab in the phase III trial (IMbrave150) improved outcomes of advanced hepatocellular carcinoma, such as overall survival and progression-free survival (6.8 versus 4.3). The paper presents the trials of atezolizumab and bevacizumab combination, demonstrates comparable data on the treatment of patients with HCC in real clinical practice and data on the phase III IMbrave150. To further analyze the efficacy of the combination of atezolizumab and bevacizumab, prospective clinical trials should include heterogeneous patient groups.

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