Sloot Sarah, Rashid Omar M, Sarnaik Arnod A, Zager Jonathan S
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
Cancer Control. 2016 Jan;23(1):12-20. doi: 10.1177/107327481602300104.
Locoregional advanced melanoma poses a complex clinical challenge that requires a multidisciplinary, patient-centered approach. Numerous agents have been studied for their suitability as intralesional therapy in the past decades, but few have successfully completed phase 3 clinical trial testing.
The relevant medical literature was searched for articles regarding use of intralesional therapies in metastatic melanoma. Therapies with data from phase 2 or higher studies were selected for review. This review also summarizes the mechanisms of action, adverse-event profiles, and clinical data for these agents.
Intralesional therapies demonstrate promising effects in select patients with advanced melanoma. The optimal approach should be individually tailored and consist of a combination of intralesional therapies, regional perfusions, systemic immunotherapies, targeted therapies, and surgery, if necessary.
Due to its relatively good local response rates and tolerable adverse-event profile, intralesional therapy may be a treatment option for select patients with unresectable, locally advanced or metastatic melanoma.
局部区域晚期黑色素瘤带来了复杂的临床挑战，需要采取多学科、以患者为中心的方法。在过去几十年中，已经对许多药物作为病灶内治疗的适用性进行了研究，但很少有药物成功完成3期临床试验测试。
检索相关医学文献，查找有关在转移性黑色素瘤中使用病灶内治疗的文章。选择有2期或更高阶段研究数据的治疗方法进行综述。本综述还总结了这些药物的作用机制、不良事件概况和临床数据。
病灶内治疗在部分晚期黑色素瘤患者中显示出有前景的效果。最佳方法应根据个体情况量身定制，必要时可包括病灶内治疗、区域灌注、全身免疫治疗、靶向治疗和手术的联合应用。
由于其相对良好的局部缓解率和可耐受的不良事件概况，病灶内治疗可能是部分不可切除、局部晚期或转移性黑色素瘤患者的一种治疗选择。
