Department of Medical Oncology, The Royal Marsden Hospital NHS Foundation Trust , London, UK.
Expert Opin Investig Drugs. 2020 Jul;29(7):739-753. doi: 10.1080/13543784.2020.1769066. Epub 2020 Jun 1.
: Advanced melanoma historically had a very poor outcome but targeted therapies and immune checkpoint inhibitors (IC) have changed the course of the disease and made durable responses possible. However, most patients will develop progressive disease, so further strategies to overcome treatment resistance are needed. : Current treatment strategies and landmark trials are discussed. Novel targeted agents, immune checkpoint inhibitors, and further immune-modulatory drugs, cancer vaccines and tumor infiltrating lymphocytes and their potential role in the treatment of melanoma are described. Current trials investigating these emerging agents and treatment strategies were searched for on ClinicalTrials.gov and are presented on the background of the current literature explaining the rationale for employing these new agents and strategies. Combinations of tumor-directed agents with those causing immune augmentation as well as a new adjuvant and neoadjuvant strategies are discussed. : Questions regarding treatment combination, personalization, and sequence of treatment will become increasingly important and will be guided by new biomarkers. New treatment settings will broaden the patient selection and will highlight the need for further discussions regarding toxicity in long-term survivorship.
: 黑色素瘤的历史预后非常差，但靶向治疗和免疫检查点抑制剂（IC）改变了疾病进程，使持久缓解成为可能。然而，大多数患者会出现疾病进展，因此需要进一步的策略来克服治疗耐药性。 : 讨论了当前的治疗策略和标志性试验。描述了新型靶向药物、免疫检查点抑制剂以及进一步的免疫调节药物、癌症疫苗和肿瘤浸润淋巴细胞及其在黑色素瘤治疗中的潜在作用。在 ClinicalTrials.gov 上搜索了正在研究这些新出现的药物和治疗策略的临床试验，并在当前文献的背景下进行了介绍，解释了使用这些新药物和策略的基本原理。讨论了肿瘤靶向药物与引起免疫增强的药物的联合应用，以及新的辅助和新辅助治疗策略。 : 关于治疗联合、个体化和治疗顺序的问题将变得越来越重要，并将由新的生物标志物指导。新的治疗环境将扩大患者选择范围，并强调需要进一步讨论长期生存者的毒性问题。
