RESUMO
In the search for alternatives to overcome the challenge imposed by drug resistance development in cancer treatment, the modulation of autophagy has emerged as a promising alternative that has achieved good results in clinical trials. Nevertheless, most of these studies have overlooked a novel and selective type of autophagy: chaperone-mediated autophagy (CMA). Following its discovery, research into CMA's contribution to tumor progression has accelerated rapidly. Therefore, we now understand that stress conditions are the primary signal responsible for modulating CMA in cancer cells. In turn, the degradation of proteins by CMA can offer important advantages for tumorigenesis, since tumor suppressor proteins are CMA targets. Such mutual interaction between the tumor microenvironment and CMA also plays a crucial part in establishing therapy resistance, making this discussion the focus of the present review. Thus, we highlight how suppression of LAMP2A can enhance the sensitivity of cancer cells to several drugs, just as downregulation of CMA activity can lead to resistance in certain cases. Given this panorama, it is important to identify selective modulators of CMA to enhance the therapeutic response.
RESUMO
A neoplasia maligna do pulmão é um dos tipos mais comuns e graves de câncer, sendo o que mais leva ao óbito em todo o mundo. O risco para o desenvolvimento desta doença depende da interação entre a exposição ao agente e a suscetibilidade individual para seu aparecimento. Acomete mais o sexo masculino e seu principal fator predisponente é o tabagismo. O objetivo deste artigo consiste em discutir a eficácia do medicamento Nivolumab no tratamento de câncer de pulmão de células não pequenas e evidenciar a imunoterapia como um tratamento promissor do câncer. Para tal, foi realizado um levantamento bibliográfico, utilizando-se como descritor: fatores de risco, câncer de pulmão, câncer de pulmão de não pequenas células em livros, artigos e revistas nas seguintes bases de dados: SCIELO, ANVISA, Periódicos da CAPES, Google Acadêmico. Em seguida, foi feita uma leitura analítica para ordenar as informações e identificar o objeto de estudo. Podemos perceber que a imunoterapia é bastante promissora, não só no tratamento do câncer de pulmão, como em muitos outros. O medicamento estudado, nivolumab, obteve ótimos resultados no tratamento de CPNPC, porém é notório que ainda falta estímulo para que o mesmo seja utilizado como primeira opção no tratamento de segunda linha do CPNPC.
Malignant neoplasm of the lung is one of the most common and serious types of cancer, and is the most deadly in the world. The risk for the development of this disease depends on the interaction between the exposure to the agent and the individual susceptibility to its onset. It affects males more and its main predisposing factor is smoking. The objective of this article is to discuss the efficacy of the drug Nivolumab in the treatment of non-small cell lung cancer and to evidence immunotherapy as a promising treatment for cancer. For that, a bibliographic survey was carried out, using as descriptor: risk factors, lung cancer, non-small cell lung cancer in books, articles and journals in the following databases: SCIELO, ANVISA, CAPES Periodicals, Google Scholar. Then, an analytical reading was made to sort the information and identify the object of study. We can see that immunotherapy is very promising, not only in the treatment of lung cancer, but also in many others. The medicament studied, nivolumab, obtained excellent results in the treatment of NSCLC, but it is well known that there is still a lack of stimulation for it to be used as the first option in the second line treatment of NSCLC.
