Specenier Pol
a Faculty of Medicine and Health Sciences , University of Antwerp , Antwerp , Belgium.
b Department of Medical Oncology , Antwerp University Hospital , Edegem , Belgium.
Expert Rev Anticancer Ther. 2016 Dec;16(12):1247-1261. doi: 10.1080/14737140.2016.1249856. Epub 2016 Nov 7.
The treatment of melanoma is evolving rapidly over the past few years. Areas covered: We conducted a comprehensive review of the literature on the role of nivolumab in melanoma Expert commentary: Nivolumab is approved by FDA and EMA for the treatment of patients with metastatic melanoma. Nivolumab is superior to chemotherapy and to ipilimumab in previously untreated patients and to chemotherapy in ipilimumab pre-treated patients. The addition ipilimumab to nivolumab is associated with a higher response rate and a better PFS, particularly in patients with PD-L1 negative tumors, albeit at the cost of an increase in grade 3-4 adverse event rate. Definitive survival data on this combination are pending and the selection of patients most likely to benefit from this combination and its pharmacoeconomics are to be elucidated. Prospectively validated predictive markers are lacking. Of particular interest are immune-related adverse events which should be managed according to published guidelines.
在过去几年中，黑色素瘤的治疗方法发展迅速。涵盖领域：我们对有关纳武单抗在黑色素瘤中作用的文献进行了全面综述。专家评论：纳武单抗已获美国食品药品监督管理局（FDA）和欧洲药品管理局（EMA）批准，用于治疗转移性黑色素瘤患者。在先前未接受治疗的患者中，纳武单抗优于化疗和伊匹单抗；在伊匹单抗预处理的患者中，纳武单抗优于化疗。纳武单抗联合伊匹单抗可提高缓解率和无进展生存期（PFS），尤其是在程序性死亡受体配体1（PD-L1）阴性肿瘤患者中，尽管这会导致3-4级不良事件发生率增加。关于这种联合治疗的确切生存数据尚未得出，最有可能从这种联合治疗中获益的患者选择及其药物经济学有待阐明。目前缺乏经过前瞻性验证的预测标志物。特别值得关注的是免疫相关不良事件，应根据已发表的指南进行处理。
