Keywords
imunoterapia
PD-1
PD-L1
biomarcadores
How to Cite
Abstract
Triple-negative breast cancer (TNBC) is one of the most aggressive forms of breast cancer, characterized by the absence of estrogen, progesterone, and HER2 receptors, which limits traditional therapeutic options and is associated with a poor prognosis. This study investigates the efficacy and safety of immunotherapy with PD-1 and PD-L1 inhibitors in the treatment of patients with TNBC. An integrative literature review included randomized and non-randomized clinical trials, observational studies, and preclinical trials that evaluated immunotherapy with PD-1 and PD-L1. The databases consulted were PubMed, Scopus, Web of Science, and Virtual Health Library (VHL), with data extracted on authors, year of publication, study type, sample size, interventions performed, outcomes evaluated, main results, and conclusions. The results showed that immunotherapy is a promising approach for the treatment of TNBC. The combination of atezolizumab with nab-paclitaxel significantly improved progression-free survival (PFS) compared to chemotherapy alone and was associated with prolonged overall survival in patients with metastatic TNBC. The presence of tumor-infiltrating lymphocytes (TILs) was identified as a predictive biomarker of better response to immunotherapy, highlighting the importance of patient selection based on biomarkers. However, challenges such as therapy resistance and immune-mediated adverse events, including pneumonitis and colitis, were frequently observed and require careful management. Despite these advances, immunotherapy with PD-1 and PD-L1 faces challenges in terms of toxicity, resistance, and cost-effectiveness, which may limit its access and broad application. Strategies to overcome these obstacles include combining immunotherapy with other treatments, such as chemotherapy and molecular pathway inhibitors, as well as developing new biomarkers for more precise patient selection. In conclusion, immunotherapy with PD-1 and PD-L1 represents new hope for patients with TNBC, but an integrated and inclusive approach is essential to maximize benefits and ensure that more patients can benefit from these therapeutic advances.
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Copyright (c) 2024 Gabriella Juliane Garcia Neves, Ana Luiza Quevedo, Luiz Antonio Lupi Júnior
