Columbia University College of Physicians and Surgeons, New York, NY, USA.
Am J Clin Dermatol. 2014 Aug;15(4):323-37. doi: 10.1007/s40257-014-0083-7.
This review summarizes results from major recent trials regarding novel therapeutic agents in melanoma. The topics discussed include targeted therapy with BRAF (V-RAF murine sarcoma viral oncogene homolog B) inhibitors (vemurafenib and dabrafenib), MEK (mitogen-activated protein kinase kinase) inhibitors (trametinib), bcr-abl/c-kit/PDGF-R inhibitors (imatinib), and angiogenesis inhibitors (bevacizumab and aflibercept), as well as immunotherapy with anti-CTLA-4 (anti-cytotoxic T-lymphocyte antigen-4) antibodies (ipilimumab), anti-PD (anti-programmed death receptor) antibodies (nivolumab and lambrolizumab), and anti-PD-L (anti-programmed death ligand) antibodies. Various combinations of these agents, as well as adjunctive GM-CSF (granulocyte-macrophage colony-stimulating factor), T-VEC (talimogene laherparepvec) oncolytic viruses, and novel chemotherapeutic agents, are also described. Despite the tremendous advances that these novel treatments have created, optimal therapeutic agent selection remains a highly individualized decision. Melanoma therapy has vastly progressed since the days when dacarbazine was the sole option for advanced melanoma patients. The molecular understanding of melanoma pathogenesis has yielded a brighter future for advanced melanoma patients.
这篇综述总结了最近几项关于黑色素瘤新型治疗药物的大型试验结果。讨论的主题包括 BRAF（V-RAF 鼠肉瘤病毒致癌基因同源物 B）抑制剂（vemurafenib 和 dabrafenib）、MEK（丝裂原活化蛋白激酶激酶）抑制剂（trametinib）、bcr-abl/c-kit/PDGF-R 抑制剂（伊马替尼）和血管生成抑制剂（贝伐单抗和 aflibercept）的靶向治疗，以及抗 CTLA-4（抗细胞毒性 T 淋巴细胞抗原-4）抗体（ipilimumab）、抗 PD（抗程序性死亡受体）抗体（nivolumab 和 lambrolizumab）和抗 PD-L（抗程序性死亡配体）抗体的免疫治疗。这些药物的各种组合，以及辅助 GM-CSF（粒细胞-巨噬细胞集落刺激因子）、T-VEC（talimogene laherparepvec）溶瘤病毒和新型化疗药物也有所描述。尽管这些新型治疗方法取得了巨大进展，但最佳治疗药物的选择仍然是一个高度个体化的决定。自达卡巴嗪成为晚期黑色素瘤患者唯一选择以来，黑色素瘤治疗已经取得了巨大进展。对黑色素瘤发病机制的分子认识为晚期黑色素瘤患者带来了更美好的未来。
