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Cancro do cólon metastático: opções terapêuticas
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Resumo(s)
O cancro do cólon é o terceiro tipo de cancro mais diagnosticado a nível mundial e o
segundo com maiores taxas de mortalidade. Devido ao seu caráter silencioso, cerca de
15 a 30% dos doentes apresentam metastização aquando do diagnóstico inicial. Por
outro lado, uma percentagem elevada (até 50%) dos cancros inicialmente localizados
progridem para patologia disseminada.
Estes dados são preocupantes, uma vez que o prognóstico diminui drasticamente para
patologia metastática, com apenas 14% de taxa de sobrevida aos 5 anos. Inicialmente,
esta era mesmo considerada uma patologia incurável; no entanto, o paradigma tem
vindo a modificar-se, com o desenvolvimento de terapêuticas mais eficazes, algumas
das quais podendo mesmo ser consideradas curativas.
Este trabalho visa reunir informações relativamente às opções terapêuticas do cancro
do cólon metastático, nomeadamente ressecção cirúrgica, esquemas de quimioterapia,
fármacos imunológicos e terapêuticas direcionadas. Tem-se, de facto, assistido ao
surgimento de um conjunto de progressos que têm alterado o desfecho desta neoplasia,
sobretudo com a evolução dos protocolos de quimioterapia, a sua combinação com
terapêuticas direcionadas e o recurso a medicina mais personalizada, na qual os
biomarcadores assumem um papel essencial. É destacado o papel do perfil mutacional
específico de cada doente na seleção do plano terapêutico, bem como o papel de
fármacos desenvolvidos recentemente, direcionados para determinados alvos
moleculares. São, também, apontadas como direções futuras a compreensão de novos
alvos moleculares e o desenvolvimento de terapêuticas direcionadas a estes alvos.
Colon cancer is the third most diagnosed type of cancer worldwide and the second with the highest mortality rates. Due to its silent nature, around 15 to 30% of patients present metastasis at the time of initial diagnosis. On the other hand, a high percentage (up to 50%) of initially localized cancers progress to disseminated pathology. These data are worrying, since the prognosis decreases drastically for metastatic pathology, with only a 14% 5-year survival rate. Initially, this was even considered an incurable pathology; however, the paradigm has been changing, with the development of more effective therapies, some of which can even be considered curative. This work aims to gather information regarding therapeutic options for metastatic colon cancer, namely surgical resection, chemotherapy regimens, immunological drugs and targeted therapies. In fact, we have witnessed the emergence of a series of advances that have changed the outcome of this neoplasm, especially with the evolution of chemotherapy protocols, their combination with targeted therapies and the use of more personalized medicine, in which biomarkers assume an essential role. The role of each patient's specific mutational profile in selecting the therapeutic plan is highlighted, as well as the role of recently developed drugs, directed at certain molecular targets. The understanding of new molecular targets and the development of therapies directed to these targets are also highlighted as future directions.
Colon cancer is the third most diagnosed type of cancer worldwide and the second with the highest mortality rates. Due to its silent nature, around 15 to 30% of patients present metastasis at the time of initial diagnosis. On the other hand, a high percentage (up to 50%) of initially localized cancers progress to disseminated pathology. These data are worrying, since the prognosis decreases drastically for metastatic pathology, with only a 14% 5-year survival rate. Initially, this was even considered an incurable pathology; however, the paradigm has been changing, with the development of more effective therapies, some of which can even be considered curative. This work aims to gather information regarding therapeutic options for metastatic colon cancer, namely surgical resection, chemotherapy regimens, immunological drugs and targeted therapies. In fact, we have witnessed the emergence of a series of advances that have changed the outcome of this neoplasm, especially with the evolution of chemotherapy protocols, their combination with targeted therapies and the use of more personalized medicine, in which biomarkers assume an essential role. The role of each patient's specific mutational profile in selecting the therapeutic plan is highlighted, as well as the role of recently developed drugs, directed at certain molecular targets. The understanding of new molecular targets and the development of therapies directed to these targets are also highlighted as future directions.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia
Palavras-chave
Cancro colorretal Metastático Fármacos direcionados Marcadores moleculares Mestrado Integrado -2024