转移性 BRAFV600 突变型黑色素瘤中联合 BRAF/MEK 抑制的成功治疗。
Successful retreatment with combined BRAF/MEK inhibition in metastatic BRAFV600-mutated melanoma.
机构信息
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland.
出版信息
J Eur Acad Dermatol Venereol. 2017 Oct;31(10):1638-1640. doi: 10.1111/jdv.14268. Epub 2017 May 8.
BACKGROUND
The combination treatment with BRAF and MEK inhibitors is amongst the current standard of care for stage IIIC/IV BRAF-mutated melanoma. However, therapeutic options are limited once patients have progressed upon both targeted and immunotherapy.
OBJECTIVE
To investigate whether retreatment with BRAF and MEK inhibitor combination is an option for patients with metastatic BRAF-mutated melanoma upon previous progression on kinase inhibitors.
METHODS
Two patients with metastatic BRAF-mutated melanoma were rechallenged with BRAF and MEK inhibitor combination after progression on targeted therapy and subsequent immunotherapy with anti-CTLA-4 and anti-PD-1 antibodies.
RESULTS
Both patients responded to retreatment. Responses were limited to a few months and associated with a considerable increase in quality of life.
CONCLUSION
Retreatment with BRAF and MEK inhibitors may present a feasible treatment option upon progression on both kinase inhibitors and immunotherapy, and should be considered when all other treatment options have been exhausted.
背景
BRAF 和 MEK 抑制剂联合治疗是 BRAF 突变型 IIIC/IV 期黑色素瘤的当前标准治疗方法之一。然而，一旦患者在靶向治疗和免疫治疗后进展，治疗选择就有限了。
目的
研究在先前接受激酶抑制剂治疗进展后，对于转移性 BRAF 突变型黑色素瘤患者，重新使用 BRAF 和 MEK 抑制剂联合治疗是否可行。
方法
两名转移性 BRAF 突变型黑色素瘤患者在接受靶向治疗和随后的抗 CTLA-4 和抗 PD-1 抗体免疫治疗进展后，重新接受 BRAF 和 MEK 抑制剂联合治疗。
结果
两名患者对重新治疗均有反应。反应持续了几个月，并显著提高了生活质量。
结论
在激酶抑制剂和免疫治疗进展后，重新使用 BRAF 和 MEK 抑制剂治疗可能是一种可行的治疗选择，应在所有其他治疗选择都已用尽时考虑。
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