皮肤黑色素瘤与免疫治疗革命(综述)。
Cutaneous melanoma and the immunotherapy revolution (Review).
机构信息
Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy.
Epidemiology Unit, IRCCS Istituto Nazionale Tumori 'Fondazione G. Pascale', I‑80131 Naples, Italy.
出版信息
Int J Oncol. 2020 Sep;57(3):609-618. doi: 10.3892/ijo.2020.5088. Epub 2020 Jun 25.
In a relatively short period of time, treatment strategies for metastatic melanoma have radically changed leading to an unprecedented improvement in patient survival. In this period, immunotherapy options have evolved from cytokine‑based approaches to antibody‑mediated inhibition of immune checkpoints, cancer vaccines and pharmacological modulation of the melanoma microenvironment. Combination of immunotherapy strategies and the association of immune checkpoint inhibitors (ICIs) with BRAF V600 targeted therapy show encouraging results. The future of drug development in this field is promising. The comprehension of primary and acquired resistance mechanisms to ICIs and the dissection of melanoma immunobiology will be instrumental for the development of new treatment strategies and to improve clinical trial design. Moreover, biomarker discovery will help patient stratification and management during immunotherapy treatment. In this review, we summarize landmark clinical trials of immune checkpoint inhibitors in advanced melanoma and discuss the rational for immunotherapy combinations. Immunotherapy approaches at early stage of clinical development and recent advances in melanoma immunotherapy biomarker development are also discussed.
在相对较短的时间内,转移性黑色素瘤的治疗策略发生了根本性变化,导致患者生存率的空前提高。在此期间,免疫治疗选择已经从基于细胞因子的方法发展为抗体介导的免疫检查点抑制、癌症疫苗和黑色素瘤微环境的药理学调节。免疫治疗策略的联合应用以及免疫检查点抑制剂(ICI)与 BRAF V600 靶向治疗的联合应用显示出令人鼓舞的结果。该领域药物研发的未来前景广阔。对 ICI 原发性和获得性耐药机制的理解以及对黑色素瘤免疫生物学的剖析,将有助于开发新的治疗策略和改进临床试验设计。此外,生物标志物的发现将有助于免疫治疗期间患者的分层和管理。在这篇综述中,我们总结了晚期黑色素瘤中免疫检查点抑制剂的标志性临床试验,并讨论了免疫治疗联合应用的合理性。还讨论了早期临床开发中的免疫治疗方法和黑色素瘤免疫治疗生物标志物开发的最新进展。