Alston Dylan, Brewer Jerry D
Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL.
Mayo Clinic, Rochester, MN, USA.
Immunotargets Ther. 2013 Feb 23;2:1-10. doi: 10.2147/ITT.S30824. eCollection 2013.
As the rate of melanoma continues to increase, so does the need for more effective and durable therapies. Despite considerable research, the management of advanced disease remains challenging. Numerous therapies are being investigated, many of which aim at upregulating the immune system's innate ability to attack the tumor. Cytotoxic T lymphocyte antigen 4 antibodies are immune stimulants that act as negative regulators of the immune system by modifying an antitumor T-cell response. Ipilimumab, one such cytotoxic T lymphocyte antigen 4 antibody, and vemurafenib, a BRAF competitive inhibitor, were approved as first-line therapies in 2011 due to improved survival rates versus standard chemotherapy. Allovectin-7 is a lipid plasmid that encodes for major histone compatibility complex DNA sequences. It has led to increases in cytotoxic T-cell production, which subsequently attacks the tumor. OncoVEX, an oncolytic herpes virus, and PV-10, a chemoablative agent, have yielded promising results in metastatic lesions and have demonstrated a unique "bystander" phenomenon. In this paper we review the basics of melanoma from the pathophysiology, risk factors, signs, diagnostic approaches, and current status of immunologic management of melanoma.
随着黑色素瘤发病率持续上升，对更有效且持久的治疗方法的需求也日益增加。尽管进行了大量研究，但晚期疾病的管理仍然具有挑战性。众多治疗方法正在研究中，其中许多旨在上调免疫系统攻击肿瘤的固有能力。细胞毒性T淋巴细胞抗原4抗体是免疫刺激剂，通过改变抗肿瘤T细胞反应来充当免疫系统的负调节因子。伊匹单抗（一种此类细胞毒性T淋巴细胞抗原4抗体）和维莫非尼（一种BRAF竞争性抑制剂）在2011年被批准作为一线治疗方法，因为与标准化疗相比，其生存率有所提高。Allovectin-7是一种脂质质粒，编码主要组织相容性复合体DNA序列。它导致细胞毒性T细胞产生增加，随后攻击肿瘤。溶瘤性疱疹病毒OncoVEX和化学消融剂PV-10在转移性病变中取得了有前景的结果，并表现出独特的“旁观者”现象。在本文中，我们从黑色素瘤的病理生理学、危险因素、体征、诊断方法以及黑色素瘤免疫管理的现状等方面回顾黑色素瘤的基础知识。
