Icon Cancer Centre Adelaide, Kurralta Park, South Australia 5037, Australia; School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Icon Cancer Centre Adelaide, Kurralta Park, South Australia 5037, Australia; Medical Oncology department, Flinders Medical Centre, Adelaide, South Australia, Australia.
Crit Rev Oncol Hematol. 2021 Nov;167:103503. doi: 10.1016/j.critrevonc.2021.103503. Epub 2021 Oct 14.
Non-cutaneous melanomas (mucosal, uveal, leptomeningeal, unknown primaries) represent around 5-10 % of all melanoma diagnoses. Non-cutaneous melanomas demonstrate differences in tumour biology, generally present with more advanced stages and have an overall poorer prognosis compared to skin melanomas. The cornerstone of their treatment is surgery followed by radiotherapy in some cases. Unfortunately, in many of these patients their melanoma will recur. Adjuvant therapy for non-cutaneous melanomas remains controversial. To date, almost all of the tested adjuvant agents have failed to demonstrate any benefit; the two randomised positive trials were criticized for methodological reasons, small sample size and conflicting results. The aim of this review is to assess the current evidence on systemic adjuvant treatments for high-risk resected non-cutaneous melanomas. We also provide a summary table with the currently recruiting clinical trials in these settings and we discuss some strategies to improve trial design in this particularly niche area of oncology.
非皮肤性黑色素瘤（黏膜、葡萄膜、软脑膜、未知原发性）约占所有黑色素瘤诊断的 5-10%。非皮肤性黑色素瘤在肿瘤生物学方面表现出差异，通常处于更晚期，与皮肤黑色素瘤相比整体预后较差。其治疗的基石是手术，某些情况下还需要放射治疗。不幸的是，在这些患者中，他们的黑色素瘤会复发。非皮肤性黑色素瘤的辅助治疗仍然存在争议。迄今为止，几乎所有经过测试的辅助药物都未能显示出任何益处；两项随机阳性试验因方法学原因、样本量小和结果相互矛盾而受到批评。本综述的目的是评估高危切除的非皮肤性黑色素瘤的全身性辅助治疗的现有证据。我们还提供了一个汇总表，其中列出了这些情况下目前正在招募的临床试验，并讨论了一些在肿瘤学这一特定利基领域中改进试验设计的策略。
