Estratégias terapêuticas no manejo do meduloblastoma pediátrico: revisão sistemática

Abstract

Introduction: Among nervous system cancers, medulloblastomas are the most frequent among children. Thus, given the prevalence that cancer has in the health of the Brazilian population, it is up to investigate therapeutic strategies, since it is a malignancy whose major issue is in morbidity after treatment. Therefore, a situation in which a quarter of patients do not survive needs advances in personalized therapy and stratification of risks for future specific treatments, something of extreme importance in heterogeneous cancers that, like meduloblastoma, require an approach focused on their subgroups and their similarities. Methodology: This study is a systematic review, with the selection of 25 Articles of the last 10 years, based on the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) for systematic reviews and meta-analyses. Results: Studies have focused on antigens that are often expressed in medulloblastoma cells, such as EPHA2. The choice of antigen is crucial for the effectiveness of the therapy, as it must be specific to tumor cells and absent in normal cells. Recent research has shown that the administration of CAR-T cells can lead to a significant reduction in tumor load in preclinical models of medulloblastoma. It showed potential to improve survival and response to treatment compared to traditional approaches, however, one should not ignore the challenges faced with its use, such as tumor recurrence. Conclusion: There are still great disparities between patients results, with a deterioration in expectation of quality of life of the survivors and the failure of aggressive high-intensity multimodal therapies to prolong the life expectancy of patients. Therefore, with this recurrent disease, the need for innovative treatment capable of uniting the clinic with the molecular is essential, something that can be leveraged with in-depth studies on the biological role of CAR-T cells.