MODERN IMMUNOLOGICAL APPROACHES TO THE SEARCH FOR BIOMARKERS PREDICTING EFFICACY AND SAFETY OF CANCER IMMUNOTHERAPY

Abstract

mmunotherapy is a powerful clinical strategy for the treatment of malignant tumours. The number of approved immuno-oncology drugs is growing, and many new therapeutic ap-proaches are currently at the stages of clinical and preclinical trials. Despite these ad-vances, a key challenge for the widespread use of immunotherapy remains the difficulty of controlled activation of the immune system. Existing approaches may cause serious side effects, including autoimmune reactions and nonspecific inflammation. In this regard, understanding the mechanisms that can increase the proportion of patients who respond to the therapy is a crucial factor both for improving treatment efficacy and for controlling its side effects. The aim of this research is to examine and summarize data on the prognostic and predictive significance of biomarkers associated with the efficacy and safety of immunotherapy in malignant tumours. The study examines molecular genetic alterations (including circulat-ing tumour DNA), cancer-testis antigens, the PD-1 protein and its ligands, as well as ter-tiary lymphoid structures. Special attention is given to biomarkers of systemic and local responses. It has been shown that the cellular composition of the tumour microenvironment and peripheral blood is associated with disease prognosis, while levels of cytokines and soluble immune factors may predict the effectiveness of immunotherapy and the likelihood of side effects. The article also discusses delayed-type hypersensitivity reactions and modern methods for detecting biomarkers, which are used to evaluate the specific anti-tumor immune response. The authors conclude that the most promising direction is the simultaneous analysis of multiple types of biomarkers using modern computational methods. This approach may improve the effectiveness and safety of immunotherapy and facilitate a transition to per-sonalized treatment.