Giunta Emilio Francesco, De Falco Vincenzo, Napolitano Stefania, Argenziano Giuseppe, Brancaccio Gabriella, Moscarella Elvira, Ciardiello Davide, Ciardiello Fortunato, Troiani Teresa
Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Ther Adv Med Oncol. 2020 Jun 19;12:1758835920925219. doi: 10.1177/1758835920925219. eCollection 2020.
mutations occur in approximately 50% of patients with metastatic melanoma. Immune-checkpoint inhibitors and targeted therapies are both active as first-line treatments in these patients regardless of their mechanisms of action and toxicities. However, an upfront therapeutic strategy is still controversial. In fact, waiting for results of ongoing clinical trials and for new biomarkers, clinicians should base their decision on the clinical characteristics of the patient and on the biological aspects of the tumor. This review provides an overview on mutations in melanoma and will discuss their prognostic and clinical significance. Moreover, it will suggest a therapeutic algorithm that can drive therapeutic choice in a first-line setting for mutant melanoma patients.
约50%的转移性黑色素瘤患者会发生突变。免疫检查点抑制剂和靶向治疗作为这些患者的一线治疗方法均有效，无论其作用机制和毒性如何。然而，前期治疗策略仍存在争议。事实上，在等待正在进行的临床试验结果和新的生物标志物时，临床医生应根据患者的临床特征和肿瘤的生物学特性做出决策。本综述概述了黑色素瘤中的突变，并将讨论其预后和临床意义。此外，还将提出一种治疗算法，可为携带突变的黑色素瘤患者的一线治疗选择提供指导。
