Dermatology Department, The Canberra Hospital, Australian National University, Level 2, Building 6, Canberra, Australian Capital Territory, Australia.
ANU Medical School, Australian National University, Acton, Canberra, ACT, 2600, Australia.
Curr Treat Options Oncol. 2020 Mar 19;21(4):29. doi: 10.1007/s11864-020-0721-7.
The treatment of advanced melanoma has undergone a dramatic transformation over the last decade with the advent of targeted and immunomodulatory therapies. This transition from cytotoxic chemotherapy has yielded improvements in both survival and quality of life; yet despite their therapeutic advantages, these treatments have been associated with a diverse range of cutaneous adverse events (AEs). These range from relatively benign eczematous conditions to more severe inflammatory and bullous disorders, and can include induction of second malignancies. AEs can result in serious morbidity and risk of mortality if not recognised and managed early. As a consequence of their novelty, and rapid uptake, these agents have been subject to intense scrutiny and there is a general understanding that cutaneous AEs should be anticipated in treatment plans. Dermatologists should be integrated into management teams to assist in the development of treatment protocols for anticipated common AEs and to provide expert management of more severe, rare or unusual AEs. Our experience has shown a reduction in treatment interruptions, more rapid recognition of unusual AEs and improved management pathways for patients suffering cutaneous AEs.
在过去的十年中，随着靶向和免疫调节疗法的出现，晚期黑色素瘤的治疗发生了巨大的转变。这种从细胞毒性化疗的转变带来了生存和生活质量的改善；然而，尽管这些治疗具有治疗优势，但它们与一系列不同的皮肤不良事件（AE）有关。这些 AE 从相对良性的湿疹样疾病到更严重的炎症和大疱性疾病不等，并且可能包括诱导第二恶性肿瘤。如果不能及早发现和治疗，AE 会导致严重的发病率和死亡率。由于它们的新颖性和快速采用，这些药物受到了严格的审查，人们普遍认为在治疗计划中应预期到皮肤 AE。皮肤科医生应纳入管理团队，以协助制定针对预期常见 AE 的治疗方案，并为更严重、罕见或不常见的 AE 提供专业管理。我们的经验表明，治疗中断减少，对不寻常 AE 的更快识别以及对患有皮肤 AE 的患者的管理途径得到了改善。
