Force Jeremy, Salama April Ks
Division of Hematology/Oncology, Duke University Medical Center, Durham, NC, USA.
Division of Hematology/Oncology, Duke University Medical Center, Durham, NC, USA; Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA.
Immunotargets Ther. 2017 Feb 13;6:1-10. doi: 10.2147/ITT.S110479. eCollection 2017.
Historically, the median overall survival of metastatic melanoma patients was less than 1 year and long-term survivors were rare. Recent advances in therapies have dramatically shifted this landscape with increased survival rates and the real possibility that long-term disease control is achievable. Advances in immune modulators, including cytotoxic T-lymphocyte antigen-4 and programmed death-1 based treatments, have been an integral part of this success. In this article, we review previous and recent therapeutic developments for metastatic melanoma patients. We discuss advances in immunotherapy while focusing on the use of nivolumab alone and in combination with other agents, including ipilimumab in advanced melanoma. One major goal in melanoma research is to optimize combination strategies allowing for more patients to experience benefit while minimizing toxicity. A better understanding of the optimal sequencing, combinations, and mechanisms underlying the development of resistance may provide evidence for rational clinical trial designs of novel immunotherapy strategies in melanoma and other cancer subtypes.
从历史上看，转移性黑色素瘤患者的中位总生存期不到1年，长期存活者很少。近年来，治疗方法的进步极大地改变了这一局面，生存率提高，长期疾病控制成为现实。免疫调节剂的进展，包括基于细胞毒性T淋巴细胞抗原4和程序性死亡1的治疗方法，是这一成功的重要组成部分。在本文中，我们回顾了转移性黑色素瘤患者以前和最近的治疗进展。我们讨论免疫治疗的进展，重点关注纳武单抗单独使用以及与其他药物联合使用，包括在晚期黑色素瘤中与伊匹单抗联合使用。黑色素瘤研究的一个主要目标是优化联合策略，使更多患者受益，同时将毒性降至最低。更好地理解最佳的序贯、联合用药以及耐药性产生的潜在机制，可能为黑色素瘤和其他癌症亚型新型免疫治疗策略的合理临床试验设计提供依据。
