• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Lancet >Cutaneous melanoma
【24h】

Cutaneous melanoma

机译：皮肤黑色素瘤

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

In the past decade, major advances have been made in the understanding of melanoma. New predisposition genes have been reported and key somatic events, such as BRAF mutation, directly translated into therapeutic management. Surgery for localised melanoma and regional lymph node metastases is the standard of care. Sentinel-node biopsy provides precise staging, but has not been reported to aff ect survival. The eff ect of lymph-node dissection on survival is a topic of investigation. Two distinct approaches have emerged to try to extend survival in patients with metastatic melanoma: immunomodulation with anti-CTLA4 monoclonal antibodies, and targeted therapy with BRAF inhibitors or MEK inhibitors for BRAF-mutated melanoma. The combination of BRAF inhibitors and MEK inhibitors might improve progression-free survival further and, possibly, increase overall survival. Response patterns diff er substantially anti-CTLA4 immunotherapy can induce long-term responses, but only in a few patients, whereas targeted drugs induce responses in most patients, but nearly all of them relapse because of pre-existing or acquired resistance. Thus, the long-term prognosis of metastatic melanoma remains poor. Anti-PD1 and anti-PDL1 antibodies have emerged as breakthrough drugs for melanoma that have high response rates and long durability. Biomarkers that have predictive value remain elusive in melanoma, although emerging data for adjuvant therapy indicate that interferon sensitivity is associated with ulceration of the primary melanoma. Intense investigation continues for clinical and biological markers that predict clinical benefi t of immunotherapeutic drugs, such as interferon alfa or anti-CTLA4 antibodies, and the mechanisms that lead to resistance of targeted drugs.
机译：在过去的十年中，对黑素瘤的认识取得了重大进展。已经报道了新的易感基因，并且关键的体细胞事件，例如BRAF突变，直接转化为治疗方法。局部黑色素瘤和局部淋巴结转移的手术是护理的标准。前哨淋巴结活检可提供精确的分期，但尚无影响生存的报道。淋巴结清扫术对生存的影响是研究的主题。已经出现了两种不同的方法来尝试延长转移性黑色素瘤患者的生存期：使用抗CTLA4单克隆抗体进行免疫调节，以及使用BRAF抑制剂或MEK抑制剂靶向治疗BRAF突变的黑色素瘤。 BRAF抑制剂和MEK抑制剂的组合可能会进一步改善无进展生存期，并可能增加总体生存期。基本上不同的抗CTLA4免疫疗法的反应模式可诱导长期反应，但仅在少数患者中发生，而靶向药物在大多数患者中可诱导反应，但几乎所有患者都因先前存在或获得性耐药而复发。因此，转移性黑色素瘤的长期预后仍然很差。抗PD1和抗PDL1抗体已成为黑素瘤的突破性药物，具有高应答率和长寿命。尽管新兴的辅助治疗数据表明干扰素敏感性与原发性黑色素瘤的溃疡形成有关，但具有预测价值的生物标志物在黑色素瘤中仍然难以捉摸。继续深入研究可预测免疫治疗药物（例如干扰素α或抗CTLA4抗体）的临床益处以及导致靶向药物耐药的机制的临床和生物学标志物。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号