Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2023 Dec 20;136(24):2923-2930. doi: 10.1097/CM9.0000000000002692. Epub 2023 May 6.
Melanoma accounts for a small proportion of skin cancers diagnosed each year, but it has a high degree of malignancy and rapid progression, resulting in a short survival period for patients. The incidence of melanoma continues to rise, and now melanoma accounts for 1.7% of cancer diagnoses worldwide and is the fifth most common cancer in the United States. With the development of high-throughput sequencing technologies, the understanding of the pathophysiology of melanoma had also been improved. The most common activating mutations in melanoma cells are BRAF , NRAS , and KIT mutations, which disrupt cell signaling pathways related to tumor proliferation. The progress has led to the emergence of molecularly targeted drugs, which extends the survival of patients with advanced melanoma. A large number of clinical trials have been conducted to confirm that targeted therapy for patients with advanced melanoma can improve progression-free survival and overall survival, and for stage III patients after radical tumor resection targeted therapy can reduce the recurrence of melanoma. Patients who were originally stage III or IV inoperable have the opportunity to achieve tumor radical resection after targeted therapy. This article reviewed the clinical trial data and summarized the clinical benefits and limitations of these therapies.
黑色素瘤每年诊断出的皮肤癌比例较小，但它具有高度恶性和快速进展，导致患者的生存期较短。黑色素瘤的发病率持续上升，现在占全球癌症诊断的 1.7%，是美国第五大常见癌症。随着高通量测序技术的发展，对黑色素瘤病理生理学的理解也得到了提高。黑色素瘤细胞中最常见的激活突变是 BRAF 、NRAS 和 KIT 突变，这些突变破坏了与肿瘤增殖相关的细胞信号通路。这一进展导致了分子靶向药物的出现，延长了晚期黑色素瘤患者的生存期。已经进行了大量的临床试验来证实，晚期黑色素瘤患者的靶向治疗可以改善无进展生存期和总生存期，对于根治性肿瘤切除后的 III 期患者，靶向治疗可以降低黑色素瘤的复发率。原本无法手术的 III 期或 IV 期患者，在接受靶向治疗后有机会实现肿瘤根治性切除。本文回顾了临床试验数据，总结了这些疗法的临床获益和局限性。
