O uso de inibidores de checkpoint imunológico na imunoterapia do câncer gástrico

Abstract

Objective: To address the use of immune checkpoint inhibitors (ICI) in the immunotherapy of gastric cancer (GC). Literature review: The main therapeutic modality of GC is surgical treatment, being the only curative option. However, immunotherapy using ICI has been a new treatment strategy for malignant neoplasms. The main immunological checkpoints are: PD-1, PD-L1 and CTLA-4; selective blockade of these inhibitory checkpoints may allow continued T cell activation, promoting effective antitumor responses. The KEYNOTE-059 study demonstrated that PD-L1 has antitumor activity and was well tolerated as monotherapy and in combination with chemotherapyPIA. The KEYNOTE-061 and 062 studies demonstrated an increased overall survival rate and a greater safety profile for patients, with a longer duration of response. The CHECKMATE-0649 study demonstrated that Nivolumab and chemotherapy had better overall survival compared to chemotherapy alone (13.1 vs. 11.1 months) with disease-free progression at 12 months of 36%. Final considerations: Clinical trials have indicated promising results with this new approach to GC, however, despite this, there are still limitations, such as irresponsiveness in some cases and the presence of significant side effects.