Davar Diwakar, Tarhini Ahmad, Kirkwood John M
Division of General Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
J Skin Cancer. 2011;2011:274382. doi: 10.1155/2011/274382. Epub 2011 Dec 19.
With an incidence that is increasing at 2-5% per year, cutaneous melanoma is an international scourge that disproportionately targets young individuals. Despite much research, the treatment of advanced disease is still quite challenging. Immunotherapy with high-dose interferon-α2b or interleukin-2 benefits a select group of patients in the adjuvant and metastatic settings, respectively, with significant attendant toxicity. Advances in the biology of malignant melanoma and the role of immunomodulatory therapy have produced advances that have stunned the field. In this paper, we review the data for the use of interferon-α2b in various dosing ranges, vaccine therapy, and the role of radiotherapy in the adjuvant setting for malignant melanoma. Recent trials in the metastatic setting using anticytoxic T-lymphocyte antigen-4 (anti-CTLA-4) monoclonal antibody therapy and BRAF inhibitor therapy have demonstrated clear benefit with prolongation of survival. Trials investigating combinations of these novel agents with existing immunomodulators are at present underway.
皮肤黑色素瘤的发病率正以每年2%至5%的速度上升，是一种严重影响全球的疾病，尤其容易侵袭年轻人。尽管进行了大量研究，但晚期黑色素瘤的治疗仍然极具挑战性。高剂量干扰素-α2b或白细胞介素-2免疫疗法分别在辅助治疗和转移性疾病治疗中使部分患者受益，但同时伴有显著的毒性。恶性黑色素瘤生物学及免疫调节治疗作用的进展令人瞩目。本文回顾了不同剂量范围使用干扰素-α2b的数据、疫苗治疗以及放射疗法在恶性黑色素瘤辅助治疗中的作用。近期在转移性疾病治疗中使用抗细胞毒性T淋巴细胞抗原-4（抗CTLA-4）单克隆抗体疗法和BRAF抑制剂疗法的试验已证明可显著延长生存期。目前正在进行将这些新型药物与现有免疫调节剂联合使用的试验。
