1st Department of Medicine, University of Athens, Medical School, Laikon General Hospital, Athens, Greece.
Cancer Treat Rev. 2013 Dec;39(8):879-85. doi: 10.1016/j.ctrv.2013.04.006. Epub 2013 May 29.
The incidence of melanoma is increasing worldwide and despite early detection and intervention, the number of patients dying from metastatic disease continues to rise. The prognosis of advanced melanoma remains poor, with median survival between 6 and 9 months. Over the past thirty years and despite extensive clinical research, the treatment options for metastatic disease were limited and melanoma is still considered as one of the most therapy-resistant malignancies. Single-agent and combination chemotherapy, hormonal therapy, biochemotherapy, immunotherapy, targeted agent therapy and combination regimes failed to show significant improvement in overall survival. Recent advances and in-depth understanding of the biology of melanoma, have contributed in the development of new agents. Based on the molecular and immunological background of the disease, the new drugs have shown benefit in overall and progression free survival. As the picture of the disease begins to change, oncologists need to alter their approach to melanoma treatment and consider disease biology together with targeted individualized treatment. In this review the authors attempt to offer an insight in present and past melanoma treatment options, with a focus on the recently approved immunotherapeutic agents and the clinical perspectives of these new weapons against metastatic melanoma.
黑色素瘤的发病率在全球范围内呈上升趋势，尽管早期发现和干预，死于转移性疾病的患者人数仍在上升。晚期黑色素瘤的预后仍然很差，中位生存期为 6 至 9 个月。在过去的三十年中，尽管进行了广泛的临床研究，但转移性疾病的治疗选择仍然有限，黑色素瘤仍然被认为是最具耐药性的恶性肿瘤之一。单药和联合化疗、激素治疗、生物化疗、免疫治疗、靶向药物治疗和联合方案未能显示总生存的显著改善。对黑色素瘤生物学的深入了解和最近的进展，促进了新药物的开发。基于疾病的分子和免疫学背景，这些新药在总生存期和无进展生存期方面显示出获益。随着疾病图谱的变化，肿瘤学家需要改变他们对黑色素瘤治疗的方法，将疾病生物学与个体化靶向治疗结合起来考虑。在这篇综述中，作者试图深入了解目前和过去的黑色素瘤治疗选择，重点介绍最近批准的免疫治疗药物，并探讨这些针对转移性黑色素瘤的新武器的临床前景。
