Sullivan Ryan J, Flaherty Keith T
Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02114, USA.
J Skin Cancer. 2011;2011:423239. doi: 10.1155/2011/423239. Epub 2011 Nov 17.
Since the initial discovery that a subset of patients with cutaneous melanoma harbor BRAF mutations, substantial research has been focused on determining the pathologic consequences of BRAF mutations, optimizing diagnostic techniques to identify these mutations, and developing therapeutic interventions to inhibit the function of this target in mutation-bearing tumors. Recently, advances have been made which are revolutionizing the standard of care for patients with BRAF mutant melanoma. This paper provides an overview on the pathogenic ramifications of mutant BRAF signaling, the latest molecular testing methods to detect BRAF mutations, and the most recent clinical data of BRAF pathway inhibitors in patients with melanoma and BRAF mutations. Finally, emerging mechanisms of resistance to BRAF inhibitors and ways of overcoming this resistance are discussed.
自从最初发现一部分皮肤黑色素瘤患者存在BRAF突变以来,大量研究集中于确定BRAF突变的病理后果、优化识别这些突变的诊断技术,以及开发治疗性干预措施以抑制该靶点在携带突变肿瘤中的功能。最近,已经取得了一些进展,正在彻底改变BRAF突变型黑色素瘤患者的治疗标准。本文概述了突变型BRAF信号传导的致病后果、检测BRAF突变的最新分子检测方法,以及BRAF通路抑制剂在黑色素瘤和BRAF突变患者中的最新临床数据。最后,讨论了对BRAF抑制剂耐药的新出现机制以及克服这种耐药性的方法。