Análise de Dados Longitudinais sobre Eficácia dos Novos Agentes Imunoterápicos em Pacientes com Melanoma Metastático

Abstract

Metastatic melanoma is an aggressive form of skin cancer characterized by the spread of tumor cells to other parts of the body, resulting in a low survival rate. Traditionally, available treatments, such as chemotherapy, had limited efficacy and significant side effects. In recent years, immunotherapy, particularly through immune checkpoint inhibitors such as nivolumab, ipilimumab, pembrolizumab, and lambrolizumab, has emerged as an innovative and promising approach in the treatment of metastatic melanoma. The objective of this systematic review is to evaluate the efficacy and safety of new immunotherapeutic agents in patients with metastatic melanoma. Specifically, studies investigating the use of nivolumab, ipilimumab, pembrolizumab, and lambrolizumab, in monotherapy or combination therapy, will be analyzed, comparing response rates, overall survival, progression-free survival, and safety profiles. This study is a systematic review of the literature. The search was conducted in the PubMed and MEDLINE databases, covering the period from 2013 to 2019. Data were independently extracted by two reviewers and analyzed descriptively and comparatively. Of the 152 studies initially identified, 8 studies were selected for the final review based on relevance and methodological quality. The studies demonstrated that the combination of nivolumab and ipilimumab results in superior response rates and survival compared to monotherapy. Pembrolizumab also proved effective, surpassing ipilimumab and chemotherapy in terms of overall survival and progression-free survival. Additionally, nivolumab and lambrolizumab showed durable tumor remission and manageable safety profiles. New immunotherapeutic agents, especially when combined, represent significant advances in the treatment of metastatic melanoma. The combination of nivolumab and ipilimumab has proven highly effective, offering sustainable long-term benefits. Pembrolizumab emerged as an effective alternative, improving survival compared to ipilimumab and chemotherapy. Future studies are essential to refine these treatment strategies and explore new therapeutic combinations that could offer even better outcomes, consolidating immunotherapy as a fundamental pillar in the management of metastatic melanoma.