Tratamento do Melanoma Maligno Metastático BRAF Mutado: Imunoterapia ou Terapêutica Dirigida?
Resumo
O melanoma metastático tem sido associado a mau prognóstico, apresentando taxas de sobrevivência global aos 5 anos de 10%. Até 2011, os únicos tratamentos disponíveis para o melanoma metastático eram a quimioterapia e a imunoterapia com interleucina-2. O conhecimento mais aprofundado sobre a biologia molecular do melanoma e a identificação de mutações BRAF, que são as mais frequentemente encontradas, permitiram encontrar novos alvos terapêuticos que vieram alterar o prognóstico destes doentes. Atualmente, os tratamentos disponíveis para o melanoma metastático com mutação BRAF são a imunoterapia com inibidores do checkpoint imunológico (anti-PD-1 e anti-CTLA-4) e a terapêutica dirigida com inibidores BRAF e inibidores MEK. No entanto, permanece ainda controverso qual a terapêutica de primeira linha a instituir nestes doentes.
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