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新型黑素瘤治疗药物的皮肤毒性。

Cutaneous toxicities of new treatments for melanoma.

机构信息

Dermatology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta/Canyet s/n., Badalona, 08016, Barcelona, Spain.

Melanoma Unit, Dermatology Department, Hospital Clinic, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), CIBERER, Universitat de Barcelona, Barcelona, Spain.

出版信息

Clin Transl Oncol. 2018 Nov;20(11):1373-1384. doi: 10.1007/s12094-018-1891-7. Epub 2018 May 24.

Abstract

New drugs against advanced melanoma have emerged during last decade. Target therapy and immunotherapy have changed the management of patients with metastatic disease. Along with its generalized use, drug toxicities have appeared and the skin is the target organ of a significant part of them. This revision summarizes the most common side effects and consensus management to improve the compliance of therapies and patients' quality of life. Among the BRAF inhibitors, main cutaneous side effects are photosensitivity, plantar hyperkeratosis, and the appearance of verrucal keratosis or squamous cell carcinoma. Special attention must be paid to the development of new primary melanomas or changes on nevi during BRAF inhibitor therapy. The most common cutaneous side effects of immunotherapy are rash, pruritus, and vitiligo. It remains controversial the possible role of these toxicities as markers of response to therapy.

摘要

过去十年中出现了针对晚期黑色素瘤的新型药物。靶向治疗和免疫疗法改变了转移性疾病患者的治疗方法。随着这些药物的广泛应用,药物毒性也随之出现,皮肤是其中很大一部分药物的靶器官。本文总结了最常见的皮肤不良反应及其共识管理方法,以提高治疗的依从性和患者的生活质量。在 BRAF 抑制剂中,主要的皮肤不良反应是光敏性、足底过度角化、疣状角化或鳞状细胞癌的出现。在 BRAF 抑制剂治疗期间,必须特别注意新原发性黑色素瘤或痣的变化。免疫治疗最常见的皮肤不良反应是皮疹、瘙痒和白癜风。这些毒性是否可能作为治疗反应的标志物仍存在争议。

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