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Terapêutica molecular nos tumores orofaríngeos
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Resumo(s)
Os tumores da orofaringe e cavidade oral integram o conjunto de neoplasias denominadas de tumores da cabeça e pescoço, apresentando importante morbilidade e mortalidade. Na última década, tem-se verificado uma mudança no paradigma da sua etiologia, com consequente revisão diagnóstica e abordagem terapêutica. Em causa, encontramos o Vírus do Papiloma Humano (HPV), um dos principais motivos pelo um aumento significativo do número de casos de tumores da orofaringe associados a este fator. Em contrapartida, temos observado uma diminuição da sua incidência associada ao tabaco e álcool. Atualmente, dispomos de um conjunto de opções terapêuticas, nomeadamente a cirurgia, radioterapia e quimioterapia, que apresentam um conjunto de efeitos adversos que motivam a procura de opções terapêuticas menos invasivas, mais eficazes e com menores efeitos adversos. A terapêutica molecular vem atender estes requisitos, apresentando potencial terapêutico comprovado com importante impacto na sobrevida e qualidade dos doentes, tratando-se de uma área em desenvolvimento, com descobertas de adicionais mecanismos fisiopatológicos e consequentes novos alvos terapêuticos. É o objetivo deste artigo de revisão, a discussão dos principais alvos terapêuticos moleculares mais conhecidos e promissores no tratamento dos tumores orofaríngeos.
Oral cavity and oropharyngeal tumors integrate the neoplasic group called Head and Neck Cancer, and are responsible for significant morbility and mortality rates. In the last decade, we have been seeing a shift in its etiologic factors, leading to a diagnostic and therapeutical approach re-assessement, for which the Human Papillomavirus (HPV) is the main cause. While we have observed a decrease in oropharyngeal cancer incidence associated with alcohol and tobacco consumption, there is a significant increase when associated with HPV. Currently, the therapies options, such as surgery, radiotherapy and chemotherapy, that we have, results in a set of side effects, that warrants the search for alternate therapies options that are less invasive, more effective and with less adverse effects. Molecular targeted therapies revealed to be promising in this field, with demonstrated significant impact in overall survival and quality of life, and are currently under constant search and development, with new findings every year regarding new physiopathology mechanisms and new therapeutics targets. It is the goal of this review to discuss the best known and promising molecular targeted therapies in the treatment of oropharyngeal cancer.
Oral cavity and oropharyngeal tumors integrate the neoplasic group called Head and Neck Cancer, and are responsible for significant morbility and mortality rates. In the last decade, we have been seeing a shift in its etiologic factors, leading to a diagnostic and therapeutical approach re-assessement, for which the Human Papillomavirus (HPV) is the main cause. While we have observed a decrease in oropharyngeal cancer incidence associated with alcohol and tobacco consumption, there is a significant increase when associated with HPV. Currently, the therapies options, such as surgery, radiotherapy and chemotherapy, that we have, results in a set of side effects, that warrants the search for alternate therapies options that are less invasive, more effective and with less adverse effects. Molecular targeted therapies revealed to be promising in this field, with demonstrated significant impact in overall survival and quality of life, and are currently under constant search and development, with new findings every year regarding new physiopathology mechanisms and new therapeutics targets. It is the goal of this review to discuss the best known and promising molecular targeted therapies in the treatment of oropharyngeal cancer.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Tumores orofaríngeos Terapêutica molecular EGFR Cetuximab Erlotinib Otorrinolaringologia