Marra Antonio, Ferrone Cristina R, Fusciello Celeste, Scognamiglio Giosue, Ferrone Soldano, Pepe Stefano, Perri Francesco, Sabbatino Francesco
Department of Medical Oncology, San Gerardo Hospital, Monza, Italy.
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States.
Anticancer Agents Med Chem. 2018;18(2):166-181. doi: 10.2174/1871520618666171219115335.
Melanoma is an aggressive form of skin cancer characterized by poor prognosis and high mortality. The development of targeted agents based on the discovery of driver mutations as well as the implementation of checkpoint inhibitor-based immunotherapy represents a major breakthrough in the treatment of metastatic melanoma. However, in both cases the development of drug resistance and immune escape mechanisms as well as the lack of predictive biomarkers limits their extraordinary clinical efficacy. In this article, we summarize the available therapeutic options for patients with metastatic melanoma, outline the mechanisms implicated in the resistance to both targeted agents and immunotherapy, discuss potential predictive biomarkers and outline future therapeutic approaches under investigation.
黑色素瘤是一种侵袭性皮肤癌,预后较差且死亡率高。基于驱动突变的发现开发靶向药物以及实施基于检查点抑制剂的免疫疗法是转移性黑色素瘤治疗的重大突破。然而,在这两种情况下,耐药性和免疫逃逸机制的出现以及缺乏预测性生物标志物都限制了它们非凡的临床疗效。在本文中,我们总结了转移性黑色素瘤患者可用的治疗选择,概述了对靶向药物和免疫疗法耐药的相关机制,讨论了潜在的预测性生物标志物,并概述了正在研究的未来治疗方法。