Lupu Jeremy, Herrscher Hugo, Robert Caroline
Service de dermatologie, institut Gustave-Roussy, Villejuif, France.
Rev Prat. 2020 May;70(5):471-474.
Immune checkpoint inhibitors for treatment of advanced stage melanoma. Immunotherapy, which stimulates the anti-tumor immune response, has significantly modified the prognosis of advanced stage melanoma. Anti-CTLA4 monoclonal antibody, ipilimumab, showed a benefit on survival compared to chemotherapy in 2011. Anti-PD1, nivolumab and pembrolizumab subsequently showed superior clinical benefit including overall survival and tolerance over anti-CTLA4. Currently, the combination of ipilimumab and nivolumab appears as the most effective immunotherapy but the toxicity of this regimen is a limitation. Anti-PD1 antibodies have also been evaluated in the adjuvant setting for patients with stage III or IV resected melanoma where they have shown a significant benefit in term of relapse-free-survival. Studies are underway to evaluate these drugs in stage II resected melanoma and in neo-adjuvant setting with promising results.
用于治疗晚期黑色素瘤的免疫检查点抑制剂。刺激抗肿瘤免疫反应的免疫疗法显著改变了晚期黑色素瘤的预后。2011年，抗CTLA4单克隆抗体伊匹单抗与化疗相比显示出对生存有益。随后，抗PD1药物纳武单抗和派姆单抗显示出优于抗CTLA4的临床益处，包括总生存期和耐受性。目前，伊匹单抗和纳武单抗联合使用似乎是最有效的免疫疗法，但该方案的毒性是一个限制因素。抗PD1抗体也已在III期或IV期切除黑色素瘤患者的辅助治疗中进行了评估，在无复发生存方面显示出显著益处。目前正在进行研究，以评估这些药物在II期切除黑色素瘤和新辅助治疗中的效果，结果令人期待。
