Câncer de mama e modulação imunológica: o papel do exercício físico na via PD-1/PD-L1 e suas implicações terapêuticas
DOI:
https://doi.org/10.5281/zenodo.19110578Palavras-chave:
câncer de mama, PD-1/PD-L1, Imunoterapia, Exercício Físico, Microambiente tumoraResumo
O câncer de mama representa a segunda neoplasia mais incidente globalmente, constituindo a principal causa de mortalidade oncológica feminina no Brasil. Este estudo apresenta o panorama epidemiológico dos subtipos mais agressivos de câncer de mama e analisa o papel do sistema imunológico na vigilância tumoral. Os subtipos mais agressivos incluem o inflamatório (2-4% dos casos), triplo-negativo (15%) e HER2 positivo, caracterizados por alta taxa de metástase e prognóstico desfavorável. O sistema imunológico exerce papel fundamental na progressão da doença, sendo os linfócitos infiltrantes no tumor (TILs) associados a prognósticos favoráveis, especialmente nos subtipos triplo-negativo e HER2 positivo. A via PD-1/PD-L1 constitui mecanismo central de escape imunológico, sendo alvo de imunoterapias que bloqueiam essa interação para potencializar a resposta antitumoral. O exercício físico emerge como estratégia complementar importante, demonstrando efeitos benéficos na redução de fatores de risco modificáveis e melhoria da qualidade de vida durante o tratamento. Estudos indicam que a atividade física pode modular a expressão de PD-1/PD-L1 no microambiente tumoral, promovendo melhor infiltração de células T citotóxicas e potencializando a eficácia das imunoterapias. A integração entre exercício físico e imunoterapia representa abordagem promissora no tratamento do câncer de mama, especialmente nos subtipos mais agressivos.
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