Динамические изменения опухолевого микроокружения под влиянием эстрадиола как диагностический критерий и мишень лекарственной терапии рака

Активация сигнального пути эстрогенового рецептора-альфа (ЭР-α) является значимым фактором в инициации канцерогенеза при различных типах опухолей ввиду геномных и негеномных эффектов эстрадиола в опухолевых клетках. Тем не менее данные об экспрессии ЭР-α и ароматазы на стромальных и иммунных клетках в микроокружении опухоли (МО) говорят о дополнительном механизме, с помощью которого эстрогены повышают злокачественность опухоли. Появляется все больше доказательств того, что МО способно влиять на опухолевый иммунитет, повышая иммунный ответ или снижая иммунореактивность.

Доказано немаловажное значение роли эстрогена и ЭР-сигнального пути в реакции микроокружения опухоли при раке различных локализаций, не только классических гормонально-зависимых опухолей. Однако клиническая эффективность блокирования влияния эстрогена на рост опухолевых клеток доказана в основном при раке женской репродуктивной системы. При этом весьма интересны данные о значимой роли микроокружения опухоли в развитии резистентности к эндокринотерапии рака молочной железы.

Несмотря на возможности стандартной терапии, более углубленное изучение роли различных компонентов МО в эволюции опухоли, создании ниши микрометастазов, а также в ответе на терапию может привести к появлению новых стратегий лечения рака. Также необходимо изучить возможности преодоления иммуносупрессивного влияния сигнального пути рецептора эстрогена на МО с целью увеличения показателей выживаемости больных гормонально-зависимыми опухолями, в частности раком молочной железы.

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