Department of Dermatology, Division of Dermatooncology, University Hospital Tübingen, Liebermeisterstrasse 25, 72076 Tübingen, Germany.
Oncologist. 2011;16(1):5-24. doi: 10.1634/theoncologist.2010-0190. Epub 2011 Jan 6.
The incidence of melanoma is increasing worldwide, and the prognosis for patients with high-risk or advanced metastatic melanoma remains poor despite advances in the field. Standard treatment for patients with thick (≥2.0 mm) primary melanoma with or without regional metastases to lymph nodes is surgery followed by adjuvant therapy or clinical trial enrollment. Adjuvant therapy with interferon-α and cancer vaccines is discussed in detail. Patients who progress to stage IV metastatic melanoma have a median survival of ≤1 year. Standard treatment with chemotherapy yields low response rates, of which few are durable. Cytokine therapy with IL-2 achieves durable benefits in a greater fraction, but it is accompanied by severe toxicities that require the patient to be hospitalized for support during treatment. A systematic literature review of treatments for advanced, metastatic disease was conducted to present the success of current treatments and the promise of those still in clinical development that may yield incremental improvements in the treatment of advanced, metastatic melanoma.
黑色素瘤的发病率在全球范围内呈上升趋势，尽管该领域取得了进展，但高危或晚期转移性黑色素瘤患者的预后仍然较差。对于有或无区域淋巴结转移的厚（≥2.0 毫米）原发性黑色素瘤患者，标准治疗是手术加辅助治疗或临床试验入组。详细讨论了干扰素-α和癌症疫苗的辅助治疗。进展为 IV 期转移性黑色素瘤的患者中位生存期≤1 年。化疗的标准治疗反应率低，其中很少有持久的。白细胞介素-2（IL-2）的细胞因子治疗在更大程度上获得了持久的益处，但伴随严重的毒性，需要患者在治疗期间住院支持。对晚期转移性疾病的治疗方法进行了系统的文献回顾，以展示当前治疗方法的成功，并展示仍处于临床开发阶段的那些可能在晚期转移性黑色素瘤治疗方面取得渐进式改善的治疗方法的前景。
