Cieľové molekuly novej generácie: ako môžu tieto molekuly zmeniť prístup k liečbe gastrointestinálnych nádorov

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Authors: S. Naizabekova ¹; S. Dyikanbaeva ²; F. Djumabaeva ²; N. Dogdurbaeva ¹; V. Sloeva ¹
Authors‘ workplace: Department of Chemotherapy, National Center for Oncology and Hematology, Bishkek, Kyrgyzstan ¹; Department of Oncology, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan ²
Published in: Gastroent Hepatol 2026; 80(3): 239-249
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.48095/ccgh2026239

Overview

Cieľom práce bolo určiť závislosť medzi molekulárnym profilom nádoru, klinickými parametrami priebehu ochorenia a dlhodobými výsledkami liečby. Štúdia bola realizovaná retrospektívnou analýzou údajov 75 pacientov s morfologicky potvrdenou diagnózou, s využitím komparatívnych, frekvenčných a stratifikovaných štatistických metód. Zistilo sa, že 84 % pacientov dosiahlo parciálnu regresiu, stabilizácia ochorenia bola zaznamenaná u 6 pacientov a frekvencia progresie dosiahla 8 %, čo umožnilo identifikovať vysokú primárnu účinnosť zvoleného lieku v prvej línii liečby. V skupine, ktorá pokračovala v monoterapii bez modifikácie protokolu, bola progresia ochorenia pozorovaná iba v 2,9 % prípadov, zatiaľ čo u pacientov, u ktorých bola liečba zmenená z dôvodu rezistencie, dosiahla frekvencia progresie 83,3 %. Najlepšie výsledky prežívania a kontroly ochorenia boli pozorované u pacientov s mutáciou v exóne 11 génu KIT, s mediánom prežívania bez progresie 30,2 mesiaca, frekvenciou parciálnej regresie nad 90 % a najnižšou úrovňou toxicity. V podskupine s mutáciou D842V génu PDGFRA prevládal progresívny priebeh, bola zaznamenaná nízka odpoveď na liečbu, skrátené obdobie klinickej stability a letálne výsledky vo viac ako 66 % prípadov pri prítomnosti metastáz. Výsledky stratifikovanej analýzy tiež potvrdili, že lokalizácia nádoru a štádium v čase diagnózy ovplyvňujú celkové prežívanie a prežívanie bez progresie. Aplikácia týchto výsledkov zdôvodňuje opodstatnenosť molekulárno-biologickej podpory v prvej línii liečby a umožňuje predikciu priebehu ochorenia. Získané údaje môžu byť využité onkológmi, molekulárnymi patomorfológmi a klinickými farmakológmi pri tvorbe individuálnych liečebných schém a pri rozhodovaní o modifikácii terapie na základe predikovanej citlivosti.

Klíčová slova:

gastrointestinální stromální tumory – inhibitory tyrosin kinázy – cílená léčba rakoviny – imatinib

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