Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Hospital Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
Clin Transl Oncol. 2024 Nov;26(11):2841-2855. doi: 10.1007/s12094-024-03497-2. Epub 2024 May 15.
Cutaneous melanoma incidence is rising. Early diagnosis and treatment administration are key for increasing the chances of survival. For patients with locoregional advanced melanoma that can be treated with complete resection, adjuvant-and more recently neoadjuvant-with targeted therapy-BRAF and MEK inhibitors-and immunotherapy-anti-PD-1-based therapies-offer opportunities to reduce the risk of relapse and distant metastases. For patients with advanced disease not amenable to radical treatment, these treatments offer an unprecedented increase in overall survival. A group of medical oncologists from the Spanish Society of Medical Oncology (SEOM) and Spanish Multidisciplinary Melanoma Group (GEM) has designed these guidelines, based on a thorough review of the best evidence available. The following guidelines try to cover all the aspects from the diagnosis-clinical, pathological, and molecular-staging, risk stratification, adjuvant therapy, advanced disease therapy, and survivor follow-up, including special situations, such as brain metastases, refractory disease, and treatment sequencing. We aim help clinicians in the decision-making process.
皮肤黑色素瘤的发病率正在上升。早期诊断和治疗管理是提高生存机会的关键。对于可通过完全切除治疗的局部晚期黑色素瘤患者,辅助治疗——最近是新辅助治疗——联合靶向治疗(BRAF 和 MEK 抑制剂)和免疫治疗(基于抗 PD-1 的治疗)提供了降低复发和远处转移风险的机会。对于无法进行根治性治疗的晚期疾病患者,这些治疗方法使总体生存率前所未有地提高。西班牙肿瘤内科学会(SEOM)和西班牙多学科黑色素瘤小组(GEM)的一组医学肿瘤学家根据现有最佳证据进行了全面审查,制定了这些指南。以下指南试图涵盖从诊断(临床、病理和分子)到分期、风险分层、辅助治疗、晚期疾病治疗和幸存者随访的所有方面,包括特殊情况,如脑转移、难治性疾病和治疗顺序。我们的目标是帮助临床医生做出决策。