Garcia-Alvarez Alejandro, Ortiz Carolina, Muñoz-Couselo Eva
Vall d'Hebron University Hospital, Medical Oncology Department, Melanoma and Other Skin Tumors Unit, Vall Hebron Institute of Oncology (VHIO), Barcelona, 08035, Spain.
Onco Targets Ther. 2021 Jun 9;14:3709-3719. doi: 10.2147/OTT.S278095. eCollection 2021.
Melanoma is the deadliest cutaneous cancer. Activating mutations in are found in 20% of melanomas. -mutant melanoma is more aggressive and, therefore, has poorer outcomes, compared to non--mutant melanoma. Despite promising preclinical data, to date immune checkpoint inhibitors remain the standard of care for locally advanced unresectable or metastatic melanoma. Data for efficacy of immunotherapy for melanoma mainly come from retrospective cohorts with divergent conclusions. MEK inhibitors have been the most developed targeted therapy approach. Although associated with an increase in progression-free survival, MEK inhibitors do not provide any benefit in terms of overall survival. Combination strategies with PI3K-AKT-mTOR pathway and CDK4/6 inhibitors seem to increase MEK inhibitors' benefit. Nevertheless, results from clinical trials are still prelaminar. A greater comprehension of the biology and intracellular interactions of -mutant melanoma will outline novel impactful strategies which could improve prognosis of these subgroup of patients.
黑色素瘤是最致命的皮肤癌。20%的黑色素瘤中存在 激活突变。与非 突变黑色素瘤相比, 突变黑色素瘤更具侵袭性,因此预后更差。尽管临床前数据很有前景,但迄今为止,免疫检查点抑制剂仍然是局部晚期不可切除或转移性黑色素瘤的标准治疗方法。黑色素瘤免疫治疗疗效的数据主要来自结论不一的回顾性队列研究。MEK抑制剂是发展最为成熟的靶向治疗方法。虽然MEK抑制剂与无进展生存期的延长相关,但在总生存期方面并未带来任何益处。与PI3K-AKT-mTOR通路和CDK4/6抑制剂的联合策略似乎能增加MEK抑制剂的疗效。然而,临床试验结果仍处于初步阶段。对 突变黑色素瘤的生物学和细胞内相互作用有更深入的了解,将勾勒出可能改善这些亚组患者预后的新的有效策略。