Department of Plastic and Reconstructive Surgery, National Institute for Cancer Research, Genova, Italy.
Cancer Treat Rev. 2012 Aug;38(5):549-53. doi: 10.1016/j.ctrv.2012.01.002. Epub 2012 Jan 24.
Uveal melanoma, which arises from melanocytes residing in the stroma, is the most common primary intraocular tumor in adults. Up to 50% of patients with primary uveal melanoma will ultimately develop distant metastasis, the liver being involved in up to 90% of individuals and the median survival reported to be 4-5 months. The current treatment of metastatic uveal melanoma is limited by the lack of effective systemic therapy. The intrinsic resistance of uveal melanoma to conventional systemic chemotherapy has led researchers to evaluate new approaches. Molecular biology and a better knowledge of cancer cells allowed the development of target therapies: these refer to drugs designed to interact with a specific molecular pathway known to have a critical role in tumor growth or progression. Several drugs, such as bevacizumab, imatinib and MEK-inhibitors, are currently under investigation as single agents or in combination with chemotherapeutic drugs for the treatment of metastatic uveal melanoma. Finally, ipilimumab, which targets the immune compartment, was reported to increase overall survival in cutaneous melanoma patients, with preliminary evidence of similar activity in ocular melanoma.
葡萄膜黑色素瘤源于基质中的黑色素细胞,是成年人最常见的原发性眼内肿瘤。多达 50%的原发性葡萄膜黑色素瘤患者最终会发生远处转移,肝脏受累者高达 90%,中位生存时间据报道为 4-5 个月。转移性葡萄膜黑色素瘤的当前治疗受到缺乏有效全身治疗的限制。葡萄膜黑色素瘤对常规全身化疗的内在耐药性促使研究人员评估新方法。分子生物学和对癌细胞的更好了解使得靶向治疗得以发展:这些药物是指旨在与已知在肿瘤生长或进展中起关键作用的特定分子途径相互作用的药物。目前正在研究几种药物,如贝伐单抗、伊马替尼和 MEK 抑制剂,作为单一药物或与化疗药物联合用于治疗转移性葡萄膜黑色素瘤。最后,针对免疫细胞群的易普利姆玛被报道可增加皮肤黑色素瘤患者的总生存期,在眼部黑色素瘤中也有类似活性的初步证据。