Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Via Mariano Semmola, 80131, Naples, Italy.
Medical Oncology and Hematology, St. Luke's University Hospital and Temple University, Bethlehem, PA, USA.
J Transl Med. 2019 Jul 22;17(1):234. doi: 10.1186/s12967-019-1979-z.
Diagnosis of melanocytic lesions, correct prognostication of patients, selection of appropriate adjuvant and systemic therapies, and prediction of response to a given therapy remain very real challenges in melanoma. Recent studies have shown that immune checkpoint blockade that represents a forefront in cancer therapy, provide responses but they are not universal. Improved understanding of the tumor microenvironment, tumor immunity and response to therapy has prompted extensive translational and clinical research in melanoma. Development of novel biomarker platforms may help to improve diagnostics and predictive accuracy for selection of patients for specific treatment. There is a growing evidence that genomic and immune features of pre-treatment tumor biopsies may correlate with response in patients with melanoma and other cancers they have yet to be fully characterized and implemented clinically. For example, advancements in sequencing and the understanding of the tumor microenvironment in melanoma have led to the use of genome sequencing and gene expression for development of multi-marker assays that show association with inflammatory state of the tumor and potential to predict response to immunotherapy. As such, melanoma serves as a model system for understanding cancer immunity and patient response to immunotherapy, either alone or in combination with other treatment modalities. Overall, the aim for the translational and clinical studies is to achieve incremental improvements through the development and identification of optimal treatment regimens, which increasingly involve doublet as well as triplet combinations, as well as through development of biomarkers to improve immune response. These and other topics in the management of melanoma were the focus of discussions at the fourth Melanoma Bridge meeting (November 29th-December 1st, 2018, Naples, Italy), which is summarised in this report.
黑素细胞病变的诊断、患者的准确预后、适当辅助和全身治疗的选择以及对特定治疗反应的预测，仍然是黑色素瘤治疗中的巨大挑战。最近的研究表明，免疫检查点阻断作为癌症治疗的前沿技术，虽然能提供疗效，但并不普遍。对肿瘤微环境、肿瘤免疫和对治疗的反应的深入理解，促使黑色素瘤领域进行了广泛的转化和临床研究。新型生物标志物平台的发展可能有助于提高诊断和预测准确性，从而选择特定治疗方法的患者。越来越多的证据表明，治疗前肿瘤活检的基因组和免疫特征可能与黑色素瘤患者的反应相关，而其他癌症的特征尚未完全确定和临床应用。例如，在黑色素瘤中测序技术的进步和对肿瘤微环境的理解，导致了使用基因组测序和基因表达来开发多标记物检测，这些检测与肿瘤炎症状态相关，具有预测免疫治疗反应的潜力。因此，黑色素瘤作为理解癌症免疫和患者对免疫治疗反应的模型系统，无论是单独使用还是与其他治疗方式联合使用。总的来说，转化和临床研究的目的是通过开发和确定最佳治疗方案来实现渐进式的改善，这些方案越来越多地涉及双联甚至三联组合，以及通过开发生物标志物来提高免疫反应。这些以及黑色素瘤管理中的其他主题是第四届黑色素瘤桥接会议（2018 年 11 月 29 日至 12 月 1 日，意大利那不勒斯）的讨论重点，本报告对此进行了总结。
