Inmunoterapia como tratamiento actual para Cáncer colorrectal. Revisión Sistemática

Abstract

Immunotherapy for colorectal cancer (CRC) has increased its development at an accelerated rate in the last 10 years. Several high-quality clinical trials have been conducted in the last decade to examine the application of programmed death receptor (1DPD-1) / programmed death ligand (PD-L1) inhibitors in patients with metastatic colorectal cancer (mCRC). However, the clinical benefits, including the effectiveness and safety of these anti-CCRCC managements, remain controversial. Objective: To analyze the efficacy of Pembrolizumab as immunotherapy in patients with colorectal cancer, using a systematic review. Methodology: In this study, a systematic review was conducted to determine the efficacy of immunotherapy as a modern treatment for CRC. Detailed searches were performed in several bibliographic databases, including PubMed, Taylor & Francis, Scopus, and ProQuest, among others, published until 2023. The search terms used were “metastatic colorectal cancer,” “immunotherapy,” “PD-1,” “PD-L1,” and study subjects at different stages of pathology were included. Relevant articles that met the established inclusion criteria were selected and analyzed. Results: Anti-PDL- 1/PD-1 (Pembrolizumab) therapy in advanced dMMR/MSI-H CRC was associated with improved survival. Anti PD-1/PD-L1 combined with anti-angiogenic drugs, targeted agents, or chemotherapy could be effective in MSS mCRC. Conclusions: Immunotherapy was effective for BRAF and KRAS/NRAS (RAS/RASRAS) mutated CRC. The high incidence of grade II and III adverse reactions at 85% reveals the importance of multidisciplinary work and further research and updates on this topic. Keywords: immunotherapy, metastatic colorectal cancer, PD-1, PD-L1, Pembrolizumab