Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, 45142, Saudi Arabia.
Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, 45142, Saudi Arabia; Division of Gynecology Oncology, Women's Health Services, Henry Ford Hospital, Detroit, MI, 48202, USA.
Crit Rev Oncol Hematol. 2018 May;125:84-88. doi: 10.1016/j.critrevonc.2018.03.005. Epub 2018 Mar 19.
Metastatic melanoma is a least common form of cancer as it accounts only for 1% of all cancer cases. But, it is most deadly in nature and is haunting mankind for long emotionally as well as economically. The sites for the onset of the disease are pigment-producing cells of the skin, mucosa, eye etc. It has the potential to spread other sites like subcutaneous tissue, lymph nodes, lungs, liver, bone and brain. The United States Food & Drug Administration has approved various drug molecules from time to time. The molecules (Dabrafenib-BRAF inhibitor and Trametinib-MEK inhibitor) have proved their credentials alone and in combination as well. These molecules have demonstrated good results for various end points like median progression free survival, overall survival, objective response etc. The median progression free survival for patients using dabrafenib and trametinib were 5.1 and 4.8 months, respectively (administered singly). It has increased to 11.4 months in the combination treatment "dabrafenib + trametinib", which is approximately 104% and 138% greater than dabrafenib and trametinib treated groups alone. Similarly, the overall survival rate and objective response rate for the patients administered with "dabrafenib + trametinib" have been increased by 72% 64%, respectively. All these increments in these parameters were for a short period of time as the molecules were unable to withstand the pressure of resistance developed in the patients. So, the current review suggests the use of BRAF and MEK inhibitors as intermittent therapy along with heat shock protein 90 (HSP90) molecules.
转移性黑色素瘤是最不常见的癌症形式，仅占所有癌症病例的 1%。但它的性质最为致命，长期以来在情感和经济上都困扰着人类。疾病的发病部位是皮肤、粘膜、眼睛等产生色素的细胞。它有可能扩散到其他部位，如皮下组织、淋巴结、肺部、肝脏、骨骼和大脑。美国食品和药物管理局不时批准各种药物分子。这些分子（达拉非尼-BRAF 抑制剂和曲美替尼-MEK 抑制剂）已单独和联合证明了它们的功效。这些分子在各种终点方面显示出了良好的效果，如中位无进展生存期、总生存期、客观缓解等。使用达拉非尼和曲美替尼的患者的中位无进展生存期分别为 5.1 个月和 4.8 个月（单独给药）。在联合治疗“达拉非尼+曲美替尼”中，这一数字增加到 11.4 个月，分别约为单独使用达拉非尼和曲美替尼治疗组的 104%和 138%。同样，接受“达拉非尼+曲美替尼”治疗的患者的总生存率和客观缓解率分别提高了 72%和 64%。所有这些参数的增加都是在短时间内发生的，因为这些分子无法承受患者体内产生的耐药性的压力。因此，目前的综述建议将 BRAF 和 MEK 抑制剂与热休克蛋白 90（HSP90）分子联合作为间歇性治疗。
