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Hepner A et al.
822 Rev Assoc Med Bras 2017; 63(9):814-823
• • M.A.P. – Honoraria (BMS, Merck); advisory role (BMS,
Amgen); research funding (BMS)
• • G.S.F. – Honoraria (Novartis, Mundipharma, Roche);
advisory role (Mundipharma, Roche, Servier); travel
expenses (Bayer, Mundipharma, Novartis, Roche, Ser-
vier); research involvement (BMS, MSD)
• • R.R.M. – Honoraria (AstraZeneca, BMS, MSD, Ro-
che, Novartis); advisory role (Roche, MSD); travel ex-
penses (AstraZeneca, BMS, MSD, Roche, TEVA, No-
vartis); research involvement (Lilly, Roche)
Resumo
Tratamento de melanoma avançado – Um panorama em
transformação
Após décadas de ostracismo, os recentes avanços no trata-
mento do melanoma trouxeram uma nova realidade para
pacientes, médicos e pesquisadores. Enquanto anticorpos
monoclonais voltados a moléculas envolvidas na modula-
ção da interação entre células do melanoma e do sistema
imune consolidaram o uso da “imunoterapia”, ummelhor
conhecimento acerca das aberrações genômicas envolvidas
na carcinogênese do melanoma viabilizaram o desenvolvi-
mento de inibidores da via mitogen-activated protein kinase
pathway (MAPK), o que também resultou em ganhos signi-
ficativos em taxas de resposta e sobrevida. Consequente-
mente, novas modalidades de tratamento foram aprovadas
para uso clínico nos Estados Unidos e na Europa, incluin-
do os bloqueadores de correceptores imunes ipilimumabe,
nivolumabe e pembrolizumabe, o herpesvírus oncolítico
talimogene laherparepvec (T-VEC), e os agentes-alvo vemu-
rafenibe, dabrafenibe, cobimetinibe e trametinibe. Nesse
artigo, revisamos os resultados que trouxeram novas alter-
nativas para a prática clínica e discutimos a incorporação
desses avanços ao cuidado de pacientes no Brasil.
Palavras-chave: melanoma, anti-PD1, anti-CTLA-4,
BRAF, MEK.
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