Palavras-chave
Eventos adversos imuno-relacionados
Imunoterapia
Inibidores de checkpoints imunológicos
Como Citar
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Resumo
Objetivo: Analisar os mecanismos de evasão imune tumoral e o impacto terapêutico dos inibidores de checkpoints imunológicos (ICIs) no tratamento de neoplasias sólidas e hematológicas, discutindo desafios clínicos e barreiras de acesso. Revisão bibliográfica: O câncer utiliza mecanismos como o eixo hipóxia–HIF-1α–CD73 e a superexpressão de PD-L1 para criar um microambiente imunossupressor composto por Tregs, MDSCs e macrófagos M2. A imunoterapia com anticorpos anti-CTLA-4, anti-PD-1 e anti-PD-L1 restaura a citotoxicidade de linfócitos T, apresentando respostas duradouras em tumores como melanoma e carcinoma pulmonar. Contudo, a eficácia é limitada pela resistência tumoral e pela ocorrência de eventos adversos imunorrelacionados (irAEs) em órgãos como pulmões e trato gastrointestinal, além da disparidade econômica global que restringe o acesso às terapias em países de baixa e média renda. Considerações finais: A imunoterapia representa um marco na oncologia moderna, embora sua consolidação dependa da identificação de biomarcadores preditivos e de estratégias que minimizem a resistência tumoral. O estudo destaca a necessidade de políticas públicas para democratizar o acesso e de um manejo clínico rigoroso dos efeitos adversos para garantir a segurança do paciente.
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