Laboratory of Tumor Targeted and Immune Therapy, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Department of Liver Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
Front Immunol. 2019 May 7;10:990. doi: 10.3389/fimmu.2019.00990. eCollection 2019.
Metastatic melanoma is the most aggressive and obstinate skin cancer with poor prognosis. Variant novel applicable regimens have emerged during the past decades intensively, while the most profound approaches are oncogene-targeted therapy and T-lymphocyte mediated immunotherapy. Although targeted therapies generated remarkable and rapid clinical responses in the majority of patients, acquired resistance was developed promptly within months leading to tumor relapse. By contrast, immunotherapies elicited long-term tumor regression. However, the overall response rate was limited. In view of the above, either targeted therapy or immunotherapy cannot elicit durable clinical responses in large range of patients. Interestingly, the advantages and limitations of these regimens happened to be complementary. An increasing number of preclinical studies and clinical trials proved a synergistic antitumor effect with the combination of targeted therapy and immunotherapy, implying a promising prospect for the treatment of metastatic melanoma. In order to achieve a better therapeutic effectiveness and reduce toxicity in patients, great efforts need to be made to illuminate multifaceted interplay between targeted therapy and immunotherapy.
转移性黑色素瘤是预后最差、侵袭性最强的皮肤癌。在过去几十年中，出现了许多新的、有潜力的治疗方案，其中最深刻的方法是针对癌基因的治疗和 T 淋巴细胞介导的免疫治疗。虽然靶向治疗在大多数患者中产生了显著而迅速的临床反应，但在数月内迅速产生了获得性耐药，导致肿瘤复发。相比之下，免疫治疗引发了长期的肿瘤消退。然而，整体反应率有限。鉴于上述情况，靶向治疗或免疫治疗都不能在大范围的患者中引发持久的临床反应。有趣的是，这些方案的优势和局限性恰好互补。越来越多的临床前研究和临床试验证明，靶向治疗和免疫治疗联合具有协同抗肿瘤作用，为治疗转移性黑色素瘤带来了广阔的前景。为了在患者中实现更好的治疗效果和降低毒性，需要努力阐明靶向治疗和免疫治疗之间的多方面相互作用。
