Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo 060-8543, Japan.
Jpn J Clin Oncol. 2021 Jan 1;51(1):3-9. doi: 10.1093/jjco/hyaa188.
Treatment with immune checkpoint inhibitors provides long-term survival for patients with advanced melanoma. Improvements in the overall survival of advanced melanoma patients have been achieved with anti-PD-1 monotherapy and anti-PD-1+ CTLA4 combination therapy, but there are still many issues to resolve. Acral, mucosal and uveal melanoma have been less responsive to immune checkpoint inhibitors than cutaneous melanoma. For patients who have achieved a good response, it is still not known how long the anti-PD-1 therapy should be administered. Moreover, there is limited treatment for patients who relapse during or after adjuvant anti-PD-1 therapy. Here, we review the current evidence regarding the clinical effects of immunotherapy for advanced melanoma. Moreover, we review previous studies of acral, mucosal and uveal melanoma, and we discuss the recent findings regarding durable response after the cessation of anti-PD-1 therapy, and treatment options for recurrence after adjuvant therapy.
免疫检查点抑制剂治疗可为晚期黑色素瘤患者提供长期生存。抗 PD-1 单药治疗和抗 PD-1+CTLA4 联合治疗已使晚期黑色素瘤患者的总生存期得到改善，但仍有许多问题亟待解决。与皮肤黑色素瘤相比，肢端、黏膜和葡萄膜黑色素瘤对免疫检查点抑制剂的反应较差。对于已获得良好反应的患者，尚不清楚 PD-1 治疗应持续多长时间。此外，对于在辅助抗 PD-1 治疗期间或之后复发的患者，治疗方法有限。在此，我们回顾了免疫疗法治疗晚期黑色素瘤的临床疗效的现有证据。此外，我们还回顾了以前关于肢端、黏膜和葡萄膜黑色素瘤的研究，并讨论了抗 PD-1 治疗停止后持久反应的最新发现，以及辅助治疗后复发的治疗选择。
