Timis Tanase, Buruiana Sanda, Dima Delia, Nistor Madalina, Muresan Ximena Maria, Cenariu Diana, Tigu Adrian-Bogdan, Tomuleasa Ciprian
Department of Hematology, Iuliu Hațieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.
Department of Oncology, Bistrița Emergency Hospital, 420094 Bistrița, Romania.
Biomedicines. 2025 Jan 3;13(1):98. doi: 10.3390/biomedicines13010098.
The incidence rate of cutaneous melanoma is on the rise worldwide, due to increased exposure to UV radiation, aging populations, and exposure to teratogen agents. However, diagnosis is more precise, and the increased number of new cases is related to the improved diagnosis tools. Despite better early diagnosis and better therapies, melanoma has remained a significant public health challenge because of its aggressive behavior and high potential for metastasis. In 2020, cutaneous melanoma constituted approximately 1.3% of all cancer deaths that occurred within the European Union, thereby highlighting the necessity for effective prevention, timely diagnosis, and sustainable treatment measures, especially as a growing number of cases occur among younger patients. Melanoma is regarded as one of the most inflamed cancers due to its high immune cell presence and strong response to immunotherapy, fueling the need for development of immune-driven innovative treatments. Approved therapies, including immune checkpoint inhibitors (e.g., anti-PD-1 and anti-CTLA-4), have notably improved survival rates in melanoma. However, the limitations of the PD-1/PD-L1 and CTLA-4 axes inhibitors, such as low response rates, treatment resistance, and toxicity, have driven the need for continued research and advancements in treatment strategies. Current clinical trials are exploring various combinations of immune checkpoint inhibitors with costimulatory receptor agonists, chemotherapy, targeted therapies, and other immunotherapies, with the goal of improving outcomes and reducing side effects for melanoma patients. Emerging approaches, including adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) and oncolytic virotherapy, are showing promise. While CAR-T cell therapy has been less successful in melanoma compared to blood cancers, ongoing research is addressing challenges like the tumor microenvironment and antigen specificity. This review provides an overview of the requirement for advances in these medications, to mark a significant step forward in melanoma management, set to bring a fresh breath of hope for patients.
由于紫外线辐射暴露增加、人口老龄化以及接触致畸剂，皮肤黑色素瘤的发病率在全球范围内呈上升趋势。然而，诊断更加精确，新病例数量的增加与诊断工具的改进有关。尽管早期诊断和治疗方法有所改善，但黑色素瘤因其侵袭性和高转移潜力，仍然是一个重大的公共卫生挑战。2020年，皮肤黑色素瘤约占欧盟所有癌症死亡病例的1.3%，这凸显了采取有效预防、及时诊断和可持续治疗措施的必要性，特别是在年轻患者中病例不断增加的情况下。黑色素瘤因其高免疫细胞存在和对免疫疗法的强烈反应，被认为是炎症最严重的癌症之一，这推动了免疫驱动创新疗法的开发需求。包括免疫检查点抑制剂（如抗PD-1和抗CTLA-4）在内的获批疗法显著提高了黑色素瘤的生存率。然而，PD-1/PD-L1和CTLA-4轴抑制剂存在局限性，如低反应率、治疗耐药性和毒性，这推动了对治疗策略持续研究和进步的需求。目前的临床试验正在探索免疫检查点抑制剂与共刺激受体激动剂、化疗、靶向治疗和其他免疫疗法的各种组合，目标是改善黑色素瘤患者的治疗效果并减少副作用。新兴方法，包括过继性肿瘤浸润淋巴细胞（TILs）细胞疗法和溶瘤病毒疗法，显示出前景。虽然与血癌相比，CAR-T细胞疗法在黑色素瘤中的成功率较低，但正在进行的研究正在解决肿瘤微环境和抗原特异性等挑战。本综述概述了这些药物进展的必要性，以在黑色素瘤管理方面迈出重要一步，为患者带来新的希望曙光。
