Yushak Melinda, Mehnert Janice, Luke Jason, Poklepovic Andrew
1 Winship Cancer Institute, Emory University, Atlanta, GA.
2 Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
Am Soc Clin Oncol Educ Book. 2019 Jan;39:e207-e211. doi: 10.1200/EDBK_239283. Epub 2019 May 17.
Over the last decade, several therapies, including both targeted and immune checkpoint inhibitors, have dramatically changed the treatment landscape for patients with metastatic melanoma. These same therapies are now being used in the adjuvant setting with the hope of delaying or preventing the development of metastatic disease. Although phase III trials have shown a clear benefit for patients with resected bulky nodal disease, treatment decisions for patients with earlier-stage (high-risk stage II and stage IIIA) melanoma in the adjuvant setting are less straightforward given the small number of patients studied so far. Among patients with stage IIIB and worse disease, both targeted and immune checkpoint inhibitors have shown benefit in recurrence-free survival. Although a head-to-head comparison has not been completed, patient and tumor characteristics can guide the optimal treatment of an individual.
在过去十年中，包括靶向治疗和免疫检查点抑制剂在内的多种疗法极大地改变了转移性黑色素瘤患者的治疗格局。目前，这些疗法也被用于辅助治疗，以期延缓或预防转移性疾病的发生。尽管III期试验已表明，对于已切除的大块淋巴结疾病患者有明显益处，但鉴于目前研究的患者数量较少，在辅助治疗中，针对早期（高危II期和IIIA期）黑色素瘤患者的治疗决策就不那么直接明了。在IIIB期及更严重疾病的患者中，靶向治疗和免疫检查点抑制剂在无复发生存方面均显示出益处。尽管尚未完成直接对比试验，但患者和肿瘤特征可指导个体的最佳治疗。
