Imunoterapia no câncer - inibidores do checkpoint imunológico
Immunotherapy and immune checkpoint inhibitors in cancer
Ataualpa Pereira dos Reis; José Augusto Nogueira Machado
Resumo
O objetivo deste trabalho é fazer uma revisão atual do tratamento de alguns tipos de câncer com imunoterapia e inibidores do checkpoint imunológico. As fontes de dados incluíram artigos originais, revisões e publicações indexados nos bancos de dados PubMed, MEDLINE, LILACS, SciELO e publicações online nos últimos 20 anos. Os checkpoints imunológicos normalmente impedem o organismo de montar uma resposta imune contra células normais. Alguns tipos de câncer podem adquirir estes checkpoints de tal forma que estas células tumorais não são reconhecidas pelo sistema imune, e isto impede que ele seja ativado. A inibição dos checkpoints imunológicos pode melhorar a sobrevida de pacientes com malignidades avançadas. Isto inclui melanoma maligno, carcinoma renal, linfoma e câncer pulmonar de células não pequenas. Uma extraordinária quantidade de investigações pré-clínicas e clínicas estão explorando o potencial terapêutico das moléculas coestimulatórias positivas e negativas. Aqui, nós revisamos o estado atual do nosso conhecimento dos mecanismos co-estimulatórios da célula T e a inibição dos checkpoints, primariamente do CTLA-4 e do PD-1.
Palavras-chave
Abstract
This paper aims to review current treatment of some types of cancer with immunotherapy and immune checkpoint inhibitors. Data sources included original articles, reviews and related texts published over the past 20 years in PubMed, MEDLINE, LILACS and SciELO databases and other online publications. Immune checkpoints normally prevent the body from developing an immune response against healthy cells. Some types of cancer may acquire these checkpoints so that the tumor cells are not recognized by the immune system, preventing it from being activated. Immune checkpoint inhibitors may improve the survival of some patients with advanced malignant tumors, including malignant melanoma, renal cell carcinoma, lymphoma and non-small cell lung cancer. An extraordinary amount of preclinical and clinical investigation is exploring the therapeutic potential of negative and positive costimulatory molecules. Herein, we review the current status of our understanding of T-cell costimulatory mechanisms and checkpoint inhibitors, primarily of CTLA-4 and PD-1.
Keywords
Referências
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Submetido em:
10/02/2020
Aceito em:
17/02/2020
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