Vargas Gracia Maria, Farooq Mohammad Saad, Karakousis Giorgos C
Division of Endocrine and Oncologic Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Cancers (Basel). 2024 Jul 29;16(15):2690. doi: 10.3390/cancers16152690.
Melanoma is the fifth most common cancer in the United States and accounts for the majority of all skin cancer-related deaths, making it the most lethal cutaneous malignancy. Systemic adjuvant therapy for stage IIB-IV melanoma is now approved for patients who have undergone surgical resection, given the appreciable risk of recurrence and mortality in this patient population. Despite the lower stage, high-risk stage II melanoma (stage IIB/IIC) can often exhibit an even more aggressive course when compared to stage IIIA/IIIB disease, thus justifying consideration of adjuvant therapy in these patients. In this review, we highlight the current standard of practice for the treatment of stage IIB/C melanoma, with a focus on adjuvant therapies supported by published landmark clinical trials, including anti-PD-1 therapy. Notably, adjuvant therapies approved thus far in this patient population have demonstrated an improvement in recurrence-free survival, while their impact on overall survival is pending. Finally, this review highlights currently ongoing trials and future directions for research and treatment possibilities for high-risk clinical stage II melanoma.
黑色素瘤是美国第五大常见癌症，占所有皮肤癌相关死亡病例的大多数，使其成为最致命的皮肤恶性肿瘤。鉴于IIB-IV期黑色素瘤患者有明显的复发和死亡风险，目前已批准对接受过手术切除的患者进行全身辅助治疗。尽管处于较低分期，但与IIIA/IIIB期疾病相比，高危II期黑色素瘤（IIB/IIC期）通常病程更具侵袭性，因此有理由考虑对这些患者进行辅助治疗。在这篇综述中，我们重点介绍了IIB/C期黑色素瘤治疗的当前实践标准，重点关注已发表的具有里程碑意义的临床试验支持的辅助治疗，包括抗PD-1治疗。值得注意的是，迄今为止在该患者群体中获批的辅助治疗已显示无复发生存期有所改善，但其对总生存期的影响仍有待确定。最后，本综述重点介绍了目前正在进行的试验以及高危临床II期黑色素瘤研究和治疗可能性的未来方向。
