The state of antitumor immunity of patients with oral cavity and oropharyngeal cancer during treatment (radiation and chemoradiation therapy), which additionally included α/β-defensin immunotherapy, was studied. In all three study groups, where preparation α/β-defensins was used, there was a more pronounced dose-dependent decrease in the relative number of lymphocytes in the blood than among those receiving cytostatic therapy in mono mode. Patients of group I received radiation therapy and immunotherapy, group II - chemoradiation and immunotherapy, group III - radiation therapy with immunotherapy in increased doses, VI - radiation, V - chemoradiation. Thus, in group І the decrease in the absolute number of lymphocytes was by 0.6×109/l, in group II - by 0.82×109/l, and in group III - by 0.93×109/l; by 8.51% there was a decrease in the relative number of lymphocytes in group I, by 15.52% in group II and in group III - by 14.32%. A significant decrease in the absolute number of CD3+ T cells in the blood was registered with a combination of radiation- and immunotherapy: in group I from 1141×106/l to 682×106/l and in group III - from 871×106/l to 309×106/l. At the same time, there was an increase in the relative number of natural killers in the blood of patients undergoing radiation therapy in combination with immunotherapy, also with a dose-dependent effect, the growth in group I is from 16 to 17% and group III - from 13.4 to 19.5%. Among patients undergoing cytostatic therapy, there were significant differences in the absolute number of NKT cells in the combination of radiation and immunotherapy, groups I and III, by reducing the number of these lymphocytes in the blood from 86 to 57 and from 62 to 31, respectively. α/β-defensins have been shown to have a dose-dependent adjuvant effect on cytostatic treatment – radiation, and chemoradiation of patients with cancer of the oral cavity and oropharynx. Simultaneously with the use of the drug α/β-defensins associated additional immunomodulatory effect in the form of the restructuring of the subpopulation of lymphocytes due to an increase in the relative number of natural killers in the blood.
Мета роботи -провести огляд наукових робіт, в яких висвітлювалися види, способи, методи імунотерапії хворих на рак порожнини рота і ротоглотки. Аналізувати результати досліджень у лікуванні раку порожнини рота і ротоглотки з використанням імунопрепаратів та можливості їх застосування. Висновки 1. Імуномодулюючі методи лікування, які долають імуносупресивні сигнали у хворих на рак порожнини рота і ротоглотки, є науково і терапевтично обґрунтованими. 2. Імунологічна терапія має потенціал для вирішення клінічних проблем у хворих на рак порожнини рота і ротоглотки шляхом поєднання із специфічними методами лікування. 3. Включення імунотерапевтичних препаратів до схеми комплексного лікування хворих на рак порожнини рота і ротоглотки значно покращує показники виживаності.
The purpose is to review the literature and analyze the use of monoclonal antibodies in the treatment for cancer of the mouth and oropharynx. Conclusions. 1. Today, cetuximab is the only monoclonal antibody that has received FDA approval for the treatment for oral and oropharyngeal cancer. Clinically used for more than 10 years, and shows good results. 2. Clinical trials have confirmed the efficacy of moAbs targeting immune checkpoint receptors, including anti-CTLA-4 and anti-PD-1. Immune checkpoint blockade may improve the existing clinical effects of therapy on the background of low toxicity and may contribute to long-term effects through immunological memory. 3. The use of immune checkpoint inhibitors is currently only approved for advanced stages of cancer. 4. There is insufficient clinical data to demonstrate the feasibility of combining several different monoclonal antibody preparations and combining them with radiation therapy or chemotherapy.
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