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№3' 2017
ONCOLOGYInternational Medical Journal, Vol. 23., Iss. 3, 2017, P. 59−67.
COMBINATION OF CHEMOTHERAPY AND IMMUNOTHERAPY IN CANCER PATIENTS TREATMENT (review)
S. P. Grigoriev Institute for Medical Radiology (NAMS of Ukraine), Kharkiv, Ukraine
Chemotherapy is one of the most widely used methods of treatment for metastatic cancer diseases. However, the effectiveness of chemotherapy, especially in treating solid tumors, is limited. Recently the interest in the use of a combination of various antitumor strategies, including chemotherapy, radiotherapy, targeted therapy and immunotherapy has grown. The recent works indicate that along with direct cytotoxic effect on the tumor cells, some chemotherapeutic agents exhibit immunomodulatory effects. Immunotropic properties of chemotherapeutic drugs related to their ability to cause immunogenic death of the tumor cells, to counteract immunosuppressive mechanisms, to exert direct or indirect effects on immune effector cells, as well as to cause transient lymphodepletion are featured. Activation of immuno−mediated mechanisms under the action of chemotherapeutic agents may contribute to enhancement of antitumor effects of immunotherapy and to achievement of better therapeutic results. This review presents the data of clinical trials of antitumor therapy combining chemotherapy with vaccination, cellular immunotherapy and blockade of immunЃEcheckpoints. The combined treatment regimens contributed to improvement of tumor response, increase in the survival of cancer patients, but had a greater toxic effect compared to monotherapy. Solution of the questions on the optimal way of combining chemo− and immunotherapy, choice of the dose and chemotherapy regimen, as well as detection of biomarkers that allow prediction of the response to combined treatment will allow to determine the role of combined strategies in the treatment of oncological diseases.
Key words: chemotherapy, immunotherapy, cancer.