CÂNCER DE MAMA TRIPLO NEGATIVO, QUIMIOTERAPIA, TRANSPORTADORES ABC, TRATAMENTO
Resumo
Introdução: O câncer de mama triplo negativo (TNBC) caracteriza-se pela não expressão de receptores hormonais de estrogênio e progesterona, e negatividade do fator de crescimento epitelial humano 2 (HER2), correspondendo até 15% dos cânceres mamários. Este tipo molecular apresenta elevado índice proliferativo, sendo mais agressivo e capaz de produzir metástases e recidivas, apresentando pior prognóstico. O tratamento cirúrgico está indicado somado, principalmente, à quimioterapia. Objetivos: Identificar tratamentos atuais do TNBC e possíveis quimiorresistências. Material e métodos: Revisão bibliográfica de artigos da plataforma PubMed.Resultados: A quimioterapia neoadjuvante é usada para estágio inicial do TNBC, com altas taxas de resposta patológica completa (PCR). Entre os medicamentos utilizados, houve melhora na PCR das pacientes tratadas com paclitaxel semanalmente e quando adicionado carboplatina e/ou bevacizumabe houve acréscimo na taxa de PCR. Já para pacientes estágio II-III, o tratamento foi com paclitaxel semanalmente e doxorrubicina lipossomal não-peguilada, somado a bevacizumab ou trastuzumabe a cada 3 semanas, com/sem a adição semanal de carboplatina. A carboplatina adicional resulta em PCR mais frequentemente, porém há maior toxicidade. No tratamento adjuvante, recomendado para casos avançados ou metastáticos, relacionados à mutação BRCA ou resistência endócrina previamente tratados com antraciclina com/sem taxano, é indicado suplementar o regime com compostos de platina ou carboplatina, sendo que paclitaxel mostrou-se eficaz. Entre as justificativas para o subconjunto que apresenta resistência quimioterápica, correlaciona-se o efluxo de drogas mediado pelos transportadores de cassete de ligação de ATP (ABC), que utilizam ATP para efluir compostos através da membrana celular. Dentre os ABCs, destaque para proteína-1 multirresistente (ABCC1/MRP1) que teve sua expressão aumentada relacionada à neoadjuvância. Outros tratamentos incluem ainda imunoterapia e inibidores da enzima poliADP-ribose polimerase. Conclusão: Apesar dos avanços na terapêutica do TNBC, são necessárias pesquisas estabelecendo protocolos de tratamento otimizados, objetivando abordagens quimioterápicas personalizadas, resultando em melhores prognósticos aos pacientes.
Publicado
2021-07-28
Como Citar
Spolador , M. E. G. ., Vasconcelos, M. T. ., Basílio, P. H. G. ., Mehanna, S. H. ., & Pereira, V. G. N. . (2021). TRATAMENTO DO CÂNCER DE MAMA TRIPLO NEGATIVO: O QUE DIZ A LITERATURA?. Revista Multidisciplinar Em Saúde, 2(3), 49. https://doi.org/10.51161/rems/1581
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