Rush University Melanoma Program and Departments of Medicine, General Surgery and Immunology and Microbiology, Rush University Medical Center, 1725 W. Harrison Street, Room 845, Chicago, IL 60612, USA.
Am J Clin Dermatol. 2013 Jun;14(3):179-94. doi: 10.1007/s40257-013-0025-9.
Melanoma is increasing in incidence and remains a major public health threat. Although the disease may be curable when identified early, advanced melanoma is characterized by widespread metastatic disease and a median survival of less than 10 months. In recent years, however, major advances in our understanding of the molecular nature of melanoma and the interaction of melanoma cells with the immune system have resulted in several new therapeutic strategies that are showing significant clinical benefit. Current therapeutic approaches include surgical resection of metastatic disease, chemotherapy, immunotherapy, and targeted therapy. Dacarbazine, interleukin-2, ipilimumab, and vemurafenib are now approved for the treatment of advanced melanoma. In addition, new combination chemotherapy regimens, monoclonal antibodies blocking the programmed death-1 (PD-1)/PD-ligand 1 pathway, and targeted therapy against CKIT, mitogen-activated protein/extracellular signal-regulated kinase (MEK), and other putative signaling pathways in melanoma are beginning to show promise in early-phase clinical trials. Further research on these modalities alone and in combination will likely be the focus of future clinical investigation and may impact the outcomes for patients with advanced melanoma.
黑色素瘤的发病率正在上升，仍然是一个主要的公共卫生威胁。尽管早期发现时该疾病可能是可治愈的，但晚期黑色素瘤的特征是广泛的转移性疾病和中位数生存时间不到 10 个月。然而，近年来，我们对黑色素瘤的分子性质以及黑色素瘤细胞与免疫系统相互作用的理解取得了重大进展，从而产生了几种新的治疗策略，这些策略显示出显著的临床获益。目前的治疗方法包括手术切除转移性疾病、化疗、免疫疗法和靶向治疗。达卡巴嗪、白细胞介素-2、易普利姆玛和威罗菲尼现已获准用于治疗晚期黑色素瘤。此外，新的联合化疗方案、阻断程序性死亡-1（PD-1）/PD-配体 1 通路的单克隆抗体以及针对 CKIT、丝裂原活化蛋白/细胞外信号调节激酶（MEK）和黑色素瘤中其他假定信号通路的靶向治疗，在早期临床试验中开始显示出前景。对这些单一疗法和联合疗法的进一步研究可能是未来临床研究的重点，并可能影响晚期黑色素瘤患者的预后。
