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A importância da imunoterapia no futuro do tratamento oncológico
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Resumo(s)
O cancro é um termo genérico de um vasto número de doenças que são caracterizadas pelo crescimento anormal de células através das suas barreiras naturais e que podem invadir os tecidos circundantes, inclusivamente outros órgãos do corpo.
As respostas do sistema imunitário são reguladas por um conjunto muito específico de recetores celulares que lhes permitem obter uma imunidade protetora contra as células cancerígenas, que é essencial para controlar o desenvolvimento gradual dos tumores, e que se designa por imunovigilância. Contudo, os tumores possuem mecanismos de fuga que conduzem ao bloqueio da resposta imunitária e ao crescimento celular descontrolado.
Apesar dos avanços na área da quimioterapia e da radioterapia, a área oncológica continua em constante evolução uma vez que ainda existem elevadas mortalidades e morbilidades. Assim surge a imunoterapia, que têm como objetivo de ativar o sistema imunitário e restaurar as respostas anti-tumorais que foram bloqueadas pelas células cancerígenas. A imunoterapia é composta por moléculas que inibem os checkpoints imunitários, por vacinas que ajudam a reforçar a ação do sistema imunitário e por técnicas de transferência celular adotiva que permitem desenvolver células com a capacidade de destruir as células tumorais.
Os vários ensaios clínicos apresentados nesta monografia comprovam o benefício clínico da imunoterapia na melhoria da sobrevida e da qualidade de vida do doente oncológico e ainda a possibilidade de conjugar a imunoterapia com a quimioterapia ou a radioterapia, para uma maior eficácia e segurança terapêutica.
Atualmente é bastante claro que, na área oncológica, nenhuma monoterapia será bem-sucedida, a não ser numa fração reduzida de doentes. Apesar de não haver estudos a longo prazo do efeito da imunoterapia, a investigação clínica avançará no sentido de aprimorar esta linha terapêutica, que representa um novo paradigma no tratamento do cancro.
Cancer is a generic term for a vast number of diseases that are characterized by the abnormal growth of cells through their natural barriers which can invade the surrounding tissues, including other organs of the body. Responses of the immune system are regulated by a very specific set of cellular receptors that give a protective immunity against cancer cells, which is essential for controlling the gradual tumor growth, and it is called immunosurveillance. However, tumors have escape mechanisms that lead to blockage of the immune response and uncontrolled cell growth. Despite the advances in chemotherapy and radiotherapy, the cancer area continues to evolve as there are still high mortalities and morbidities. Thus, immunotherapy appears, which aim to activate the immune system and restore the anti-tumor responses that have been blocked by the cancer cells. Immunotherapy is composed of molecules that inhibit immune checkpoints, by vaccines that help boost the action of the immune system and by adoptive cell transfer techniques that enable cells with the ability to destroy tumor cells to be developed. The several clinical trials used in this monograph demonstrate the clinical benefit of immunotherapy in improving the life and quality of life of the cancer patient and also the possibility of combining immunotherapy with chemotherapy or radiotherapy for greater efficacy and therapeutic safety. It is now quite clear that, in the oncology area, monotherapy won’t be successful, except in a reduced fraction of patients. Although there are no long-term clinical trials of the effects of immunotherapy, clinical investigation will progress with the aim to improve this therapy, which represents a new paradigm in the treatment of cancer.
Cancer is a generic term for a vast number of diseases that are characterized by the abnormal growth of cells through their natural barriers which can invade the surrounding tissues, including other organs of the body. Responses of the immune system are regulated by a very specific set of cellular receptors that give a protective immunity against cancer cells, which is essential for controlling the gradual tumor growth, and it is called immunosurveillance. However, tumors have escape mechanisms that lead to blockage of the immune response and uncontrolled cell growth. Despite the advances in chemotherapy and radiotherapy, the cancer area continues to evolve as there are still high mortalities and morbidities. Thus, immunotherapy appears, which aim to activate the immune system and restore the anti-tumor responses that have been blocked by the cancer cells. Immunotherapy is composed of molecules that inhibit immune checkpoints, by vaccines that help boost the action of the immune system and by adoptive cell transfer techniques that enable cells with the ability to destroy tumor cells to be developed. The several clinical trials used in this monograph demonstrate the clinical benefit of immunotherapy in improving the life and quality of life of the cancer patient and also the possibility of combining immunotherapy with chemotherapy or radiotherapy for greater efficacy and therapeutic safety. It is now quite clear that, in the oncology area, monotherapy won’t be successful, except in a reduced fraction of patients. Although there are no long-term clinical trials of the effects of immunotherapy, clinical investigation will progress with the aim to improve this therapy, which represents a new paradigm in the treatment of cancer.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2017
Palavras-chave
Imunoterapia Checkpoint imunitário Transferência celular adotiva Sipuleucel-T Mestrado Integrado - 2017