From the Case Western Reserve University School of Medicine.
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH.
J Comput Assist Tomogr. 2022;46(4):621-632. doi: 10.1097/RCT.0000000000001315. Epub 2022 Jun 4.
Treatment strategies for malignant melanoma have rapidly evolved over the past decade. Because of its propensity to develop advanced stage and metastatic disease, melanoma has contributed to the majority of mortalities among patients with skin cancer. The development of novel therapeutics such as immunotherapy and targeted molecular therapies has revolutionized the treatment of patients with advanced stage and metastatic malignant melanoma. Immune checkpoint inhibitors, BRAF/MEK inhibitors, and other revolutionary therapies have demonstrated remarkable success in the treatment of this common malignancy. Along with these advancements in systemic therapies, imaging has continued to play a critical role in the diagnosis and follow-up of patients with malignant melanoma. As the use of these novel therapies continues to expand, knowledge of the evolving therapeutic landscape of melanoma is becoming critical for radiologists. In this review, we provide a primer for radiologists outlining the evolution of immunotherapy and targeted therapy in the treatment of melanoma. We discuss the critical role of imaging in evaluation of treatment response, including a summary of current imaging response guidelines. Last, we summarize the essential role of imaging in the evaluation of potential adverse events seen in patients with malignant melanoma undergoing treatment with immune checkpoint inhibitors.
在过去的十年中，恶性黑素瘤的治疗策略迅速发展。由于其发展为晚期和转移性疾病的倾向，黑素瘤导致了皮肤癌患者死亡的大部分原因。免疫疗法和靶向分子疗法等新型疗法的发展彻底改变了晚期和转移性恶性黑素瘤患者的治疗方法。免疫检查点抑制剂、BRAF/MEK 抑制剂和其他革命性疗法在治疗这种常见恶性肿瘤方面取得了显著成功。随着这些系统治疗方法的进步，影像学在恶性黑素瘤患者的诊断和随访中继续发挥关键作用。随着这些新型疗法的不断应用，了解黑素瘤的治疗领域的不断发展对于放射科医生变得至关重要。在这篇综述中，我们为放射科医生提供了一个概述，介绍了免疫疗法和靶向治疗在黑素瘤治疗中的发展。我们讨论了影像学在评估治疗反应中的关键作用，包括当前影像学反应指南的总结。最后，我们总结了影像学在评估接受免疫检查点抑制剂治疗的恶性黑素瘤患者潜在不良反应方面的重要作用。
