First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
First Medical Oncology Clinic, Saint-Savvas Anticancer Hospital, Athens, Greece.
Expert Opin Investig Drugs. 2021 May;30(5):555-569. doi: 10.1080/13543784.2021.1898587. Epub 2021 Mar 11.
Uveal melanoma (UM) is the most common intraocular cancer and represents a discrete subtype of melanoma. Metastatic disease, which occurs in half of patients, has a dismal prognosis. Immunotherapy with immune checkpoint inhibitors has produced promising results in cutaneous melanoma but has failed to show analogous efficacy in metastatic UM. This is attributable to UM's distinct genetics and its complex interaction with the immune system. Hence, more efficacious immunotherapeutic approaches are under investigation.
We discuss those novel immunotherapeutic strategies in clinical and preclinical studies for advanced disease and which are thought to overcome the hurdles set by UM in terms of immune recognition. We also highlight the need to determine predictive markers in relation to these strategies to improve clinical outcomes. We used a simple narrative analysis to summarize the data. The search methodology is located in the Introduction.
Novel immunotherapeutic strategies focus on transforming immune excluded tumor microenvironment in metastatic UM to T cell inflamed. Preliminary results of approaches such as vaccines, adoptive cell transfer and other novel molecules are encouraging. Factors such as HLA compatibility and expression level of targeted antigens should be considered to optimize personalized management.
葡萄膜黑色素瘤（UM）是最常见的眼内癌，是黑色素瘤的一个特殊亚型。约有一半的患者会发生转移性疾病，预后极差。免疫检查点抑制剂的免疫疗法在皮肤黑色素瘤中已取得了令人瞩目的效果，但在转移性 UM 中却未能显示出类似的疗效。这归因于 UM 独特的遗传学特征及其与免疫系统的复杂相互作用。因此，正在研究更有效的免疫治疗方法。
我们讨论了那些在晚期疾病的临床前和临床研究中针对 UM 的新型免疫治疗策略，这些策略被认为克服了 UM 在免疫识别方面的障碍。我们还强调需要确定与这些策略相关的预测标志物，以改善临床结果。我们使用简单的叙述性分析来总结数据。搜索方法位于引言中。
新型免疫治疗策略的重点是将转移性 UM 中免疫排斥的肿瘤微环境转化为 T 细胞浸润的环境。疫苗、过继细胞转移和其他新型分子等方法的初步结果令人鼓舞。应考虑 HLA 相容性和靶向抗原的表达水平等因素，以优化个性化管理。
