Simon Aurélien, Kourie Hampig Raphael, Kerger Joseph
Jules Bordet Institute, Free University of Brussels, Brussels, Belgium.
Chin J Cancer. 2017 Jan 13;36(1):10. doi: 10.1186/s40880-017-0179-6.
Metastatic melanoma has long been considered to have a very poor prognosis and to be chemo-resistant. However, a subgroup of patients with metastatic melanoma presents remarkable responses to chemotherapeutic agents, even in the absence of a response to modern targeted therapies and immunotherapies; accordingly, determining predictive biomarkers of the response to chemotherapies for metastatic melanoma remains a priority to guide treatment in these patients. We report a case study of a patient with B-Raf proto-oncogene serine/threonine kinase-mutated metastatic melanoma harbouring many genetic mutations. The patient did not respond to prior targeted therapies or immunotherapies but experienced a dramatic objective radiological and clinical response to subsequent dacarbazine-based chemotherapy. In the era of targeted therapies and immunotherapies for metastatic melanoma, cytotoxic chemotherapies may still represent an interesting therapeutic weapon in a well-defined subgroup of patients presenting with specific genetic and molecular features.
长期以来，转移性黑色素瘤一直被认为预后很差且具有化疗耐药性。然而，一部分转移性黑色素瘤患者对化疗药物表现出显著反应，即使对现代靶向治疗和免疫治疗无反应；因此，确定转移性黑色素瘤化疗反应的预测生物标志物仍然是指导这些患者治疗的首要任务。我们报告了一例携带多种基因突变的B-Raf原癌基因丝氨酸/苏氨酸激酶突变型转移性黑色素瘤患者的病例研究。该患者对先前的靶向治疗或免疫治疗均无反应，但对随后基于达卡巴嗪的化疗出现了显著的客观影像学和临床反应。在转移性黑色素瘤的靶向治疗和免疫治疗时代，细胞毒性化疗在具有特定遗传和分子特征的明确患者亚组中可能仍然是一种有吸引力的治疗手段。
