Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC213210.15690/vramn2132ENDOCRINOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ЭНДОКРИНОЛОГИИReview ArticleTreatment of Parathyroid Cancer: Current Status and Near-Term ProspectsЛечение рака околощитовидных желез: текущее состояние и ближайшие перспективыhttps://orcid.org/0000-0001-7879-84951628-2139KimEkaterina I.КимЕкатерина Игоревна
Russian Federation

MD, PhD Student

врач-эндокринолог, аспирант

kat-alex2007@mail.ruhttps://orcid.org/0000-0001-7963-50226279-8247KrupinovaJulia A.КрупиноваЮлия Александровна
Russian Federation

MD, PhD

врач-эндокринолог, к.м.н.

j.krupinova@gmail.comhttps://orcid.org/0000-0002-8216-517X5531-6435BelousovPavel V.БелоусовПавел Владимирович
Russian Federation

Senior Research Associate

старший научный сотрудник

belousp@gmail.comhttps://orcid.org/0000-0003-4748-6362TrutnevaKseniya А.ТрутневаКсения Александровна
Russian Federation

Researcher, PhD in Biology

научный сотрудник, к.б.н.

trutneva-k@mail.ruhttps://orcid.org/0000-0002-9717-97425624-3875MokryshevaNatalya G.МокрышеваНаталья Георгиевна
Russian Federation

MD, PhD, Professor

д.м.н., профессор

mokrisheva.natalia@endocrincentr.ruEndocrinology Research CentreНациональный медицинский исследовательский центр эндокринологии281220227753623702706202203112022Copyright ©; 2022, "Paediatrician" Publishers LLCCopyright ©; 2022, Издательство "Педиатръ"2022"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/2132

Parathyroid cancer (PС) is a rare malignant neoplasm of the endocrine system, characterized by a severe course due to the development of life-threatening hypercalcemia. Despite a relatively high survival rate, recurrence occurs about half the time. The aggressive course of PС is associated with both local spread of the process and distant metastasis. With the exception of isolated cases, cytotoxic chemo- and radiotherapy are inefficacious, and treatment protocols have not been developed. Therefore the only effective way is the surgical removal of secondary lesions, which is not always technically feasible and is associated with a high risk of postoperative complications. The literature describes individual cases of successful use of targeted therapy, as well as immunotherapy in the form of therapeutic vaccination to induce an immune response against parathyroid hormone (PTH) and block immune checkpoint. A promising direction of study is the tumor immunoenvironment, which has both diagnostic and prognostic value in relation to the likelihood of the spread of the tumor process. In this review, we describe the main directions in the treatment of PC, including disseminated forms, the possibilities of immunotherapy will be considered in details.

Рак околощитовидных желез (ОЩЖ) — редкое злокачественное новообразование эндокринной системы, характеризующееся тяжелым течением вследствие развития жизнеугрожающей гиперкальциемии. Несмотря на относительно высокую выживаемость, рецидив возникает примерно в половине случаев. Агрессивное течение рака ОЩЖ ассоциировано как с локальным распространением процесса, так и с отдаленным метастазированием. За исключением единичных случаев, эффективность цитотоксической химио- и лучевой терапии при лечении рака ОЩЖ низкая, а протоколы лечения не разработаны, поэтому основным способом лечения остается хирургическое удаление вторичных очагов, что не всегда технически выполнимо и сопряжено с высоким риском послеоперационных осложнений. В литературе описаны отдельные случаи успешного применения таргетной терапии, а также иммунотерапии в формате терапевтической вакцинации с целью индукции иммунного ответа против паратиреоидного гормона (ПТГ) и блокировки контрольных точек иммунного ответа. Перспективное направление — изучение иммуноокружения опухоли, которое имеет как диагностическую, так и прогностическую ценность в отношении вероятности распространения опухолевого процесса. Данный обзор посвящен основным направлениям в лечении рака ОЩЖ, в том числе диссеминированных форм, подробно рассмотрены возможности и перспективы иммунотерапии.

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