Uso de Imunoterapia no Câncer de Ovário Avançado: Revisão Sistemática

Maria Luiza Congro Rodrigues; Giulia Candida Ribeiro Garnes; Alexandre Mizutani Mori; Henrique Bettiol Coronado Barelli; Victoria Caroliny Silva Sena; Nina Petroni Haiat; Estela Merlone de Toledo; Bruna Marinelli Rodrigues

doi:10.36489/nursing.2025v30i331p12443-12463

Authors

Maria Luiza Congro Rodrigues Universidade para o Desenvolvimento do Estado do Pantanal (UNIDERP) https://orcid.org/0000-0002-9522-7376
Giulia Candida Ribeiro Garnes Universidade Estadual do Mato Grosso do Sul https://orcid.org/0009-0005-3723-2782
Alexandre Mizutani Mori Universidade do Oeste Paulista https://orcid.org/0009-0007-8234-0445
Henrique Bettiol Coronado Barelli Universidade do Oeste Paulista https://orcid.org/0009-0002-8254-0002
Victoria Caroliny Silva Sena Faculdade Morgana Potrich – FAMP. https://orcid.org/0009-0003-5582-1885
Nina Petroni Haiat Centro Universitário Lusíada (UNILUS) https://orcid.org/0000-0002-8341-326X
Estela Merlone de Toledo Universidade para o Desenvolvimento do Estado do Pantanal (UNIDERP) https://orcid.org/0009-0004-0222-9965
Bruna Marinelli Rodrigues Residência de Radioterapia pela Escola Paulista de Medicina (EPM); São Paulo; SP https://orcid.org/0000-0002-4952-7968

DOI:

https://doi.org/10.36489/nursing.2025v30i331p12443-12463

Keywords:

Advanced ovarian cancer, Immunotherapy, Immune checkpoint inhibitors, Biomarkers, Combination therapy, Personalized medicine

Abstract

Introduction: Advanced ovarian cancer is one of the most lethal gynecologic malignancies, characterized by high recurrence rates and resistance to conventional treatments based on surgery and platinum-based chemotherapy. Methodology: The review was conducted according to the PRISMA protocol, including articles published between 2016 and 2024 in the PubMed, Scopus, Web of Science, and
ScienceDirect databases. Studies addressing the use of immunotherapy — alone or in combination — in patients with advanced or recurrent ovarian cancer were selected. Results: Monotherapy with immune checkpoint inhibitors showed modest response rates, attributed to low mutational burden and an immunosuppressive tumor microenvironment. In contrast, combinatory strategies — involving ICIs with antiangiogenic agents, PARP inhibitors, vaccines, and STING/TLR agonists — showed superior results in subgroups of patients selected by biomarkers and immune profiles. Therapeutic vaccines and cellular therapies, including TILs and CAR-T cells, demonstrated promising potential, especially in minimal residual disease settings. The development of tumor immunophenotypes has proven to be a relevant tool for individualized treatment. Conclusion: Immunotherapy in advanced ovarian cancer is undergoing scientific consolidation, with encouraging results in combination and biomarker-guided approaches. Although it has not yet achieved a significant impact on overall survival, advances in personalized therapies and the understanding of the tumor microenvironment represent decisive milestones toward a new era in gynecologic oncology.

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References

Aalipour, S., Zoghi, S., Khalili, N., Hirbod-Mobarakeh, A., Emens, L. A., & Rezaei, N. (2016). Specific immunotherapy in ovarian cancer: A systematic review. Immunotherapy, 8(10), 1193–1204. https://doi.org/10.2217/imt-2016-0045

Siminiak, N., Czepczyński, R., Zaborowski, M. P., & Iżycki, D. (2022). Immunotherapy in ovarian cancer. Archivum Immunologiae et Therapiae Experimentalis, 70(1), 19. https://doi.org/10.1007/s00005-022-00655-8

Odunsi, K., et al. (2021). Immunotherapy in ovarian cancer: Thinking beyond PD-1/PD-L1. Frontiers in Oncology, 11, 795547. https://doi.org/10.3389/fonc.2021.795547

Zeng, Y., et al. (2020). Immunotherapy for ovarian cancer: Adjuvant, combination and multi-modal approaches. Frontiers in Immunology, 11, 577869. https://doi.org/10.3389/fimmu.2020.577869

Liang, R., Xu, J., et al. (2022). Evolution of immunotherapy for ovarian cancer from a bird’s-eye perspective: A text-mining analysis of 20 years of research. Frontiers in Oncology, 12, 795129. https://doi.org/10.3389/fonc.2022.795129

Yang, M., Li, Z., et al. (2022). Efficacy evaluation of multi-immunotherapy in ovarian cancer: From bench to bedside. Frontiers in Immunology, 13, 1034903. https://doi.org/10.3389/fimmu.2022.1034903

Wei, S., & Zhang, C. (2023). Limitations and potential of immunotherapy in ovarian cancer. Frontiers in Immunology, 14, 1292166. https://doi.org/10.3389/fimmu.2023.1292166

Pimenta, T. M., Souza, J. C., Martins, B. S., et al. (2024). Emerging strategies to overcome ovarian cancer: Advances in immunotherapy. Frontiers in Pharmacology, 15, 1490896. https://doi.org/10.3389/fphar.2024.1490896

Ghisoni, E., Morotti, M., Sarivalasis, A., et al. (2024). Immunotherapy for ovarian cancer: Towards a tailored immunophenotype-based approach. Nature Reviews Clinical Oncology. https://doi.org/10.1038/s41571-024-00937-4

Zhang, Y., Chen, X., & Liu, Y. (2024). Navigating immunotherapy for ovarian cancer: Current landscape and future directions. Journal of Cancer Drug Resistance, 7(3), 238–255. https://doi.org/10.20517/jcdr.2024.38

Wu, Q., Tang, L., et al. (2024). Promising new drugs and therapeutic approaches for treatment of ovarian cancer. BMC Medicine, 22, 256. https://doi.org/10.1186/s12916-024-03826-w

Li, M., & Zhou, J. (2020). Immunotherapy in ovarian cancer. Annals of Oncology, 31(9), 1141–1153. https://doi.org/10.1016/j.annonc.2020.06.020

Chen, X., Wang, H., et al. (2023). Worldwide research trends on the immunotherapy of ovarian cancer: A bibliometric analysis. Journal of Multidisciplinary Healthcare, 16, 2923–2939. https://doi.org/10.2147/JMDH.S526280

Cheng, W., Ma, C., & Liu, J. (2024). Immunotherapy for ovarian cancer: New challenges and future perspectives. Cancer Immunology, Immunotherapy, 73(2), 567–582. https://doi.org/10.1007/s00262-023-03457-1

Singh, R., & Tewari, K. S. (2023). Checkpoint inhibitors and ovarian cancer: Current status and future promise. Gynecologic Oncology Reports, 47, 101217. https://doi.org/10.1016/j.gore.2023.101217

Yamada, Y., Tanaka, H., et al. (2024). Advances in immunotherapeutic strategies for recurrent and advanced ovarian cancer. International Journal of Molecular Sciences, 25(3), 1764.