Radiation and polychemotherapy significantly affect the immune system of a cancer patient, unabling to adequately respond to infectious agents and provide effective antitumor protection. Rehabilitation of immune disorders is an urgent task, the solution of which will contribute to the generalization of experience when suing the immune modulators in cancer patients. To summarize the existing data on the use of concomitant immune therapy in antitumor treatment, the reports published within 30 years in Pubmed, Cochrane Library, ScienceDirect and the Vernadsky National Library of Ukraine were analyzed. It is expedient to use immune correction at different stages of antitumor treatment in the case of compliance with certain criteria for the prescribing the immune modulatory drugs. Their use is most justified after the primary tumor removal, even in the presence of metastases, because the increase in antitumor resistance is achieved in the absence of tumor cells in the patient's body or their presence in minimal quantities. Possibilities and goals of concomitant immune therapy in cancer patients should be considered taking into account the stage of treatment. Immune modulators with additional properties (detoxification, antioxidant) can serve as universal drugs. In the early post−surgery period, it is advisable to use the drugs, affecting the cells of the mononuclear phagocyte system for the prevention of postoperative infectious complications. During radiation and chemotherapy, preference should be given to the drugs with antitoxic effects and capable of preventing the leukopenia development. Thus, the prescribing of concomitant immune therapy in the combined treatment of cancer patients is an important task, demanding a balanced approach. Key words: immune therapy, immune modulators, quality of life, cancer patients.

Aim: To study the expression of the programmed cell death receptor (PD-1) and its ligand (PD-L1) by immunocompetent cells in endometrial cancer patients with metabolic disorders. Materials and Methods: Populations and subpopulations of lymphocytes were analyzed by flow cytometry. Antibodies against CD279 were used to detect PD-1 on the CD4+ and CD8+ T cells. Antibodies against CD14 and CD274 were used to detect PD-L1 on monocytes. Results: In patients with severe metabolic disorders, the expression of PD-1 on CD8+ and CD4+ lymphocytes and the expression of the corresponding PD-L1 on CD14+ cells before treatment and after radiation therapy were higher than in the control group. Conclusion: Theincreased expression of PD-1 and PD-L1 receptors by immunocompetent cells can be considered a new prognostic marker in endometrial cancer patients with morbid obesity.

Background. Immune disorders in antitumor treatment of obese patients may depend on the severity of the inflammatory process, which justifies the need to take into account the intensity of the latter in the analysis of complications of antitumor treatment in obese individuals. Purpose – evaluation of immune disorders after radiation therapy in obese patients with different intensity of the inflammatory process.  Materials and methods. 65 patients with stage I–II endometrial cancer underwent pangysterectomy and a postoperative course of remote gamma therapy. Examinations were performed before treatment and after radiation therapy. Subpopulation composition of lymphocytes, phagocytic activity of neutrophils, levels of circulating immune complexes and immunoglobulins G, A, M were determined by standard methods. The SF-3000 «SYSMEX» analyzer was used to evaluate hematological parameters. The level of C-reactive protein (CRP) was determined using an analyzer «RESPONS 910». Insulin and leptin levels were assessed by enzyme-linked immunosorbent assay. Results and discussion. Immune and hematological parameters were evaluated in 3 groups of patients. Group I included patients with normal body weight (BMI < 25), II and III groups consisted of obese patients (BMI > 30). Group II included patients with a CRP level below the median, which was 18,0 mg/l, group III – patients with a CRP level above 18.0 mg/l. In patients of group II there was a higher absolute and relative number of lymphocytes, the absolute number of CD3+-, CD4+- and CD8+-lymphocytes compared with those registered in groups I and III. After radiation therapy, the absolute number of lymphocytes and lymphocyte subpopulations decreased in all groups. As before treatment, higher levels of these indicators were registered in group II. In obese patients, the relative number of NK cells was lower than that determined in patients of group I before and after treatment. Conclusions. Patients with obesity and low intensity of the inflammatory process have less pronounced immune disorders after radiation therapy compared with patients who had a normal body weight and individuals with obesity and high levels of CRP.

Despite advances in early detection and treatment, breast cancer remains the deadliest oncopathology for women worldwide. Today there is an urgent need for new approaches to this disease treatment. Recently, immune therapy, especially inhibitors of immune checkpoints, has taken the lead when fighting against cancer. Blocking immune checkpoints is an effective approach to enhance the effector T cell function. Immune checkpoint blockers, namely inhibitors of cytotoxic T−lymphocyte−associated antigen 4 (CTLA−4), programmed cell death protein 1 (PD−1) and ligand 1 of programmed cell death protein 1 (PD−L1) are approved by the US Food and Drug Association (FDA) to be used in various solid tumors, refractory cancers with microsatellite instability, classical Hodgkin's lymphoma. In March 2019, the first inhibitor for the treatment of breast cancer was approved, i.e. atezolizumab (anti−PD−L1) in combination with nab−paclitaxel in the patients with metastatic triple−negative breast cancer, which aroused the interest of experts in the study of immunotherapeutic agents for the treatment of these patients. The review presents the results of using the inhibitors of immune control points in monotherapy and in combination with standard methods of antitumor treatment (chemotherapy and radiotherapy, targeted therapy) in patients with breast cancer. Information on potential biomarkers of response to immunotherapy in breast cancer is presented. Key words: breast cancer, checkpoint inhibitors, biomarkers of response.