Tasdogan Alpaslan, Sullivan Ryan J, Katalinic Alexander, Lebbe Celeste, Whitaker Dagmar, Puig Susana, van de Poll-Franse Lonneke V, Massi Daniela, Schadendorf Dirk
Department of Dermatology, University Hospital Essen & German Cancer Consortium (DKTK), Partner Site Essen, Essen, Germany.
National Center for Tumour diseases (NCT-West), Campus Essen & Research Alliance Ruhr, Research Center One Health, University Duisburg-Essen, Essen, Germany.
Nat Rev Dis Primers. 2025 Apr 3;11(1):23. doi: 10.1038/s41572-025-00603-8.
Cutaneous melanoma is a common cancer in Australia and New Zealand, Europe, and North America, and its incidence is still increasing in many regions. Ultraviolet (UV) radiation exposure (for example, through excessive sunlight exposure) remains the primary risk factor for melanoma; however, public awareness campaigns have led to a marked reduction in mortality. In addition to genetic damage from UV radiation, specific genetic alterations have been linked to melanoma. The stage of the tumour at the time of diagnosis is of greater importance for melanoma prognosis than in almost any other cancer. Context-dependent genetic mutations that attenuate tumour-suppressive mechanisms or activate growth-promoting signalling pathways are crucial factors in the development of cutaneous melanoma. In addition to external factors such as UV radiation, the tumour microenvironment can contribute to melanoma progression, invasion and metastasis. Cutaneous melanoma treatment has improved considerably over the past decade with the discovery and development of immune checkpoint inhibitors and therapy targeting BRAF and MEK. Over the next decade, several priorities are likely to influence melanoma research and management, including the continued advance of precision medicine methods to identify the most suitable patients for the most effective treatment, with the aim of improving clinical outcomes.
皮肤黑色素瘤在澳大利亚、新西兰、欧洲和北美是一种常见癌症,并且在许多地区其发病率仍在上升。紫外线(UV)辐射暴露(例如,通过过度暴露于阳光下)仍然是黑色素瘤的主要危险因素;然而,公众意识宣传活动已导致死亡率显著降低。除了紫外线辐射造成的基因损伤外,特定的基因改变也与黑色素瘤有关。与几乎任何其他癌症相比,黑色素瘤诊断时的肿瘤分期对其预后更为重要。减弱肿瘤抑制机制或激活促生长信号通路的上下文依赖性基因突变是皮肤黑色素瘤发生发展的关键因素。除了紫外线辐射等外部因素外,肿瘤微环境也会促进黑色素瘤的进展、侵袭和转移。在过去十年中,随着免疫检查点抑制剂以及针对BRAF和MEK的疗法的发现与发展,皮肤黑色素瘤的治疗有了显著改善。在接下来的十年里,几个优先事项可能会影响黑色素瘤的研究和管理,包括精准医学方法的持续推进,以确定最适合接受最有效治疗的患者,目的是改善临床结果。