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Immunotherapy. 2011 Dec;3(12):1461-9. doi: 10.2217/imt.11.136.
The incidence of cutaneous melanoma is on the rise worldwide despite increasing awareness and vigilance towards prevention by the lay public and health professionals. Melanoma is easily curable by surgical excision when detected early, but it is nearly incurable when discovered in its later stages owing to resistance to treatment. Unfortunately, treatment options traditionally used in melanoma have not shown a survival benefit. However, as the understanding of tumor biology and metastatic growth evolves, new therapeutic options for metastatic melanoma have shown impressive survival benefit. The blockade of cytotoxic T-lymphocyte antigen 4 (CTLA-4) by use of the monoclonal antibody, ipilimumab (Yervoy™, Bristol-Myers Squibb), produces favorable antitumor immune system responses and was recently approved by the US FDA for use in patients with advanced melanoma. In addition, targeting components of the MAPK pathway have also demonstrated survival advantage in patients with BRAF-mutated melanoma and vemurafenib (Zelboraf™, Plexxikon/Roche) was approved by the FDA in August 2011 for the first-line treatment of both metastatic and unresectable melanomas for patients whose tumors have V600E mutations in the BRAF gene.
尽管公众和卫生专业人员对预防的认识和警惕性不断提高，但全球范围内皮肤黑色素瘤的发病率仍在上升。当黑色素瘤早期被发现时，通过手术切除很容易治愈，但由于对治疗的抵抗力，当发现处于晚期时几乎无法治愈。不幸的是，传统上用于黑色素瘤的治疗方法并没有显示出生存获益。然而，随着对肿瘤生物学和转移性生长的理解的发展，转移性黑色素瘤的新治疗选择已显示出令人印象深刻的生存获益。使用单克隆抗体伊匹单抗（Yervoy™，百时美施贵宝）阻断细胞毒性 T 淋巴细胞抗原 4（CTLA-4）可产生有利的抗肿瘤免疫系统反应，最近已被美国 FDA 批准用于治疗晚期黑色素瘤患者。此外，针对 MAPK 通路的靶向药物在 BRAF 突变黑色素瘤患者中也显示出生存优势，vemurafenib（Zelboraf™，Plexxikon/Roche）于 2011 年 8 月被 FDA 批准用于 BRAF 基因 V600E 突变的转移性和不可切除黑色素瘤患者的一线治疗。
