Atkinson Victoria
University of Queensland, Brisbane, Queensland, Australia.
Cancer Care Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Intern Med J. 2017 Oct;47(10):1114-1121. doi: 10.1111/imj.13574.
In Australia, there is a high incidence of melanoma, and until recently, the treatment and median overall survival for advanced metastatic melanoma had not changed in decades. The recognition of BRAF as an important tumour oncogene in melanoma has led to the development of targeted therapies, and in the last few years, we have seen the impact of these therapies, with significant improvement in response rate, duration of disease control and overall survival for patients with BRAF mutation-positive metastatic melanoma. Concurrently, the science of immunotherapy has evolved beyond the knowledge of the importance of the immune system in cancer, leading to the development of checkpoint inhibitors. The development of checkpoint inhibitors as a tolerable and effective therapy for metastatic melanoma, which has demonstrated improved response rates, duration of control and overall survival for patients, has implications beyond the care of patients with metastatic melanoma as these therapies are being trialled in other malignancies. This article will review the current standard of care and available therapies for metastatic malignant melanoma.
在澳大利亚,黑色素瘤的发病率很高,直到最近,晚期转移性黑色素瘤的治疗方法和中位总生存期在几十年里都没有改变。BRAF作为黑色素瘤中一种重要的肿瘤致癌基因被发现后,靶向治疗应运而生。在过去几年里,我们已经看到了这些治疗方法的效果,BRAF突变阳性转移性黑色素瘤患者的缓解率、疾病控制持续时间和总生存期都有了显著改善。与此同时,免疫治疗科学已经超越了免疫系统在癌症中重要性的认知,催生了检查点抑制剂的研发。检查点抑制剂作为转移性黑色素瘤一种可耐受且有效的治疗方法,已证明能提高患者的缓解率、控制持续时间和总生存期,其影响不仅限于转移性黑色素瘤患者的治疗,因为这些疗法正在其他恶性肿瘤中进行试验。本文将综述转移性恶性黑色素瘤的当前治疗标准和可用疗法。