Weide Benjamin, Neri Dario, Elia Giuliano
Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany.
Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Cancer Immunol Immunother. 2017 May;66(5):647-656. doi: 10.1007/s00262-016-1952-0. Epub 2017 Jan 11.
Intralesional therapy of melanoma patients with locally advanced metastatic disease is attracting increasing interest, not least due to its ability to lead to both direct tumor cell killing and the stimulation of both a local and a systemic immune response. An obvious pre-requisite for this type of approach is the presence of accessible metastases that are amenable to direct injection with the therapeutic agent of interest. Patients who present with these characteristics belong to stages IIIB/C or IV of the disease. Surgical resection with intention to cure is the standard of care for patients with limited tumor burden and confined spread of disease (resectable patients). However, this category of patients is at a high risk of further recurrences until the disease becomes inoperable (unresectable) or progresses to a more advanced stage with visceral organ involvement, after which the prognosis is particularly grim. Most of the intralesional treatments tested so far, including the recently approved oncolytic virus talimogene laherparepvec, target the subpopulation of patients with unresectable disease, but the possibility to use the intralesional treatment in a neoadjuvant setting for fully resectable patients is attracting considerable interest. The present article reviews approved products and advanced stage pharmaceutical agents in development for the intralesional treatment of melanoma patients.
对局部晚期转移性黑色素瘤患者进行瘤内治疗正吸引着越来越多的关注，这尤其是因为它既能直接杀死肿瘤细胞，又能刺激局部和全身免疫反应。这种治疗方法的一个明显前提是存在可触及的转移灶，适合直接注射感兴趣的治疗药物。具有这些特征的患者属于疾病的IIIB/C期或IV期。对于肿瘤负荷有限且疾病扩散局限的患者（可切除患者），以治愈为目的的手术切除是标准治疗方法。然而，这类患者在疾病变得无法手术切除（不可切除）或进展到更晚期并累及内脏器官之前，有很高的进一步复发风险，在此之后预后尤其严峻。到目前为止测试的大多数瘤内治疗方法（包括最近获批的溶瘤病毒塔利莫基因拉赫帕里韦克）都针对不可切除疾病的患者群体，但在新辅助治疗中对完全可切除患者使用瘤内治疗的可能性正引起相当大的兴趣。本文综述了已获批的产品以及正在研发的用于黑色素瘤患者瘤内治疗的晚期药物。
