Imunoterapia no tratamento de cânceres ginecológicos: Eficácia, aplicabilidade e perspectivas.

Abstract

Introduction: Immunotherapy has emerged as an innovative therapeutic approach in the treatment of multidrug-resistant gynecological cancers, offering effective alternatives for patients unresponsive to conventional therapies. Objective: To describe the efficacy, safety, and applicability of immunotherapy in endometrial, cervical, ovarian, vulvar, and vaginal cancers, based on the scientific literature published between 2013 and 2023. Methodology: This study performed an integrative review of the scientific literature, based on data collected from the PubMed/MEDLINE, Scopus, Web of Science, Embase, and SciELO databases, using search terms such as: "gynecologic cancer", "ovarian cancer", "endometrial cancer", "cervical cancer", "vulvar cancer", "vaginal cancer", combined with "immunotherapy", "checkpoint inhibitors", "PD-1 inhibitors", "CTLA-4 blockade", "CAR-T cells", and "cancer vaccines", connected by Boolean operators (AND, OR). The search was limited to studies published between 2013 and 2023, in English, Portuguese, and Spanish, in order to ensure the inclusion of recent and relevant scientific evidence. Results: The results indicate that molecular subgroups, such as MSI-high and PD-L1-positive tumors, present a better response to immune checkpoint inhibitors. Combined approaches with antiangiogenic agents, chemotherapy, and PARP inhibitors increased efficacy in resistant scenarios. However, challenges such as immune- mediated toxicity, high cost, and gaps in research on rare subtypes limit the widespread application of immunotherapy. Final Considerations: The need for strategies that prioritize the development of biomarkers, cost-effective therapeutic combinations, and public policies that guarantee access in vulnerable populations is highlighted.