Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
Lancet Oncol. 2015 Oct;16(13):e486-97. doi: 10.1016/S1470-2045(15)00141-2.
Melanoma is a leading cause of lost productivity due to premature cancer mortality. Melanoma frequently spreads to the brain and is associated with rapid deterioration in quality and quantity of life. Until now, treatment options have been restricted to surgery and radiotherapy, although neither modality has been well studied in clinical trials. However, the new immune checkpoint inhibitors and molecularly targeted agents that have been introduced for treatment of metastatic melanoma are active against brain metastases and offer new opportunities to improve disease outcomes. New challenges arise, including how to integrate or sequence multiple treatment modalities, and current practice varies widely. In this Review, we summarise evidence for the treatment of melanoma brain metastases, and discuss the rationale and evidence for combination modalities, highlighting areas for future research.
黑色素瘤是导致因癌症过早死亡而导致生产力损失的主要原因。黑色素瘤经常扩散到大脑，并与生活质量和数量的迅速恶化相关。到目前为止，治疗选择仅限于手术和放疗，尽管这两种方法都没有在临床试验中得到很好的研究。然而，新的免疫检查点抑制剂和分子靶向药物已被引入治疗转移性黑色素瘤，对脑转移有效，并为改善疾病结果提供了新的机会。新的挑战出现了，包括如何整合或序贯多种治疗方式，目前的实践差异很大。在这篇综述中，我们总结了治疗黑色素瘤脑转移的证据，并讨论了联合治疗方式的原理和证据，突出了未来研究的领域。
