Dados do Resumo

Título

The evolution and impact of immunological therapies in cancer treatment

Introdução

Immunotherapy has ushered in a new era of revolution in cancer treatment. The clinical goal of cancer immunotherapy is to prime the host's immune system to provide passive or active immunity against malignant tumors. Several immunotherapies result in durable clinical responses. They have the potential to avoid invasive treatments such as radio and chemotherapy, offering a better safety profile. However, effectiveness varies and not all patient profiles are suitable for the treatment.

Objetivo

Analyze the impact and evolution of response and survival rates of immunological therapies when in comparison to conventional oncological treatments.

Métodos

To achieve the objective of the study, a review was carried out based on published studies indexed in PubMed and Lilacs. Descriptors were consulted in the Health Science Descriptors (DeCS) “Evolution”, “Impact”, “immunotherapy” and “cancer treatment” combined with the Boolean operator AND. The research revealed 156 articles in PubMed and 36 in Lilacs on the topic of interest. Articles were included if they presented relevance to the proposed topic and were published between 2019 and 2024. Articles that do not address immunotherapy or its impacts, incomplete articles, letters to the editor, editorials, case reports and case series were excluded from the research. Twenty four articles were included.

Resultados

Studies confirm that the heterogeneity of the tumor microenvironment (TME) is strongly associated with poor response to immunotherapy in various types of cancer, including cholangiocarcinoma and hepatocellular carcinoma. Modulation of the TME, such as manipulation of macrophages, has shown potential to stimulate the immune response to the tumor, with variable therapeutic efficacy. In preclinical models of glioblastoma, immunotherapy was able to modulate the TME and inhibit tumor growth in rats. Furthermore, tumor burden in plasma (PTMB) proved to be a more reliable prognostic marker than tissue tumor burden (TMB) in patients undergoing immunotherapy. Checkpoint inhibition immunotherapy showed potential efficacy in acute leukemias and brain metastases.

Conclusões

Despite being promising, as evidenced in cases of glioblastoma, acute leukemias and brain metastases, immunotherapy faces challenges due to the heterogeneity of the tumor microenvironment. Therefore, individualized approaches that account for the genetic and immunological heterogeneity of tumors are crucial to maximize the efficacy of immunotherapy across various types of cancer.

Palavras Chave

immunological therapies; Câncer; treatment