ANALYSIS OF THE SCIENTIFIC EVIDENCE OF THE EFFECTIVENESS OF IMMUNOMODULATION IN NEOPLASMS: A SYSTEMATIC REVIEW

Introduction: Immunomodulators are drugs used for the treatment of diseases, whose main objective is to stimulate or reduce the immune response. Accordingly, the increasing use of multiple immunomodulatory agents is occurring for cancer therapies due to the possibility of controlling the growth and development of these tumors by activating the immune response directed at neoplastic cells. Objective: To analyze the scientific evidence of studies on the effectiveness of immunomodulation in neoplasms. Methods: This is a systematic review that followed the recommended steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA. We adopted the PICO strategy, which guided the research question: What is the scientific evidence indicated by the studies regarding the effectiveness of immunomodulation in neoplasms? In order to answer this question, we searched for studies in the respective databases, such as PubMed, Scopus, CINAHL, Web of Science and The Cochrane Data Base, using the descriptors in English, selected from the Medical Subject Headings (MeSH). Accordingly, we identified eight articles in the databases. Soon after the cataloging process, we decided to analyze only clinical trials, by means of the Consolidated Standards of Reporting Trials – CONSORT. With this, we considered the studies that reached a percentage of methodological quality greater than and equal to 75%, categorized as satisfactory. Accordingly, the final sample of the study was three articles. Results: The analysis of the studies reveal that immunomodulators have an average efficacy rate of 56% for some neoplasms. A randomized clinical trial found that Vitamin D, as an immunomodulator, decreases the relative risk for colon, breast, and prostate cancer. In another clinical trial, it was noted that intraperitoneal administration of cyclophosphamide (Cy) had a good therapeutic effect in eradicating 100% of the lymphomas and 83% of the sarcomas, with no metastatic growths or recurrences being observed in the primary site of both tumors. In a doubleblind study in Beijing, immunomodulation was successful in increasing the survival of patients with endocrine (52%) and dermatological (45%) cancers that had low-grade immune-related adverse events (irAEs) (57%). Conclusion: Immunomodulatory therapy is evidenced as an advance in cancer therapy by presenting promising results, showing effectiveness for certain neoplasms.