Li Jun, Wang Yujue, Liang Ruijing, An Xiangjie, Wang Ke, Shen Guanxin, Tu Yating, Zhu Jintao, Tao Juan
Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, PR China.
School of Chemistry & Chemical Engineering and National Engineering Center for Nanomedicine, HUST, Wuhan 430074, PR China.
Nanomedicine. 2015 Apr;11(3):769-94. doi: 10.1016/j.nano.2014.11.006. Epub 2014 Dec 30.
Melanoma is one of the most aggressive skin cancers, notorious for its high multidrug resistance and low survival rate. Conventional therapies (e.g., dacarbazine, interferon-alpha-2b and interleukin-2) are limited by low response rate and demonstrate no overall survival benefit. Novel targeted therapies (e.g., vemurafenib, dabrafenib and trametinib) have higher initial response rate and clear impact on the overall survival, but relapse usually occurs within 6 to 9 months. Although immunotherapy (e.g., ipilimumab, pembrolizumab and nivolumab) can achieve long-term and durable response, rate of adverse events is extremely high. With the development of nanotechnology, the applications of nanocarriers are widely expected to change the landscape of melanoma therapy for foreseeable future. In this review, we will relate recent advances in the application of multifunctional nanocarriers for targeted drug delivery to melanoma, in melanoma nanotheranostics and combination therapy, and nanopharmaceutical associated melanoma clinical trials, followed by challenges and perspectives. From the clinical editor: The team of authors describes the current treatment regimes of malignant melanoma emphasizing the importance of achieving a better efficacy and the need to develop a better understanding of melanoma tumorigenesis.
黑色素瘤是最具侵袭性的皮肤癌之一，以其高多药耐药性和低生存率而臭名昭著。传统疗法（如达卡巴嗪、干扰素-α-2b和白细胞介素-2）受到低反应率的限制，且未显示出总体生存获益。新型靶向疗法（如维莫非尼、达拉非尼和曲美替尼）具有较高的初始反应率，对总体生存有明显影响，但通常在6至9个月内复发。尽管免疫疗法（如伊匹木单抗、派姆单抗和纳武单抗）可实现长期持久反应，但不良事件发生率极高。随着纳米技术的发展，人们广泛期望纳米载体的应用在可预见的未来改变黑色素瘤治疗的格局。在本综述中，我们将阐述多功能纳米载体在黑色素瘤靶向药物递送、黑色素瘤纳米诊疗与联合治疗以及纳米药物相关黑色素瘤临床试验中的最新进展，随后探讨挑战与展望。临床编辑评论：作者团队描述了恶性黑色素瘤的当前治疗方案，强调了实现更好疗效的重要性以及深入了解黑色素瘤肿瘤发生机制的必要性。
