Melanoma

被引:1074
作者
Schadendorf, Dirk [1 ,2 ]
van Akkooi, Alexander C. J. [3 ]
Berking, Carola [4 ]
Griewank, Klaus G. [1 ,2 ]
Gutzmer, Ralf [5 ]
Hauschild, Axel [6 ]
Stang, Andreas [7 ,8 ]
Roesch, Alexander [1 ,2 ]
Ugurel, Selma [1 ,2 ]
机构
[1] Univ Hosp Essen, Dept Dermatol, D-45122 Essen, Germany
[2] German Canc Consortium, Heidelberg, Germany
[3] Netherlands Canc Inst Antoni van Leeuwenhoek, Dept Surg Oncol, Amsterdam, Netherlands
[4] Univ Hosp Munich, Dept Dermatol & Allergy, Munich, Germany
[5] Hannover Med Sch, Skin Canc Ctr Hannover, Dept Dermatol, Hannover, Germany
[6] Univ Hosp, Dept Dermatol, Kiel, Germany
[7] Univ Hosp Essen, Inst Med Informat Biometry & Epidemiol, Ctr Clin Epidemiol, Essen, Germany
[8] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
关键词
DABRAFENIB PLUS TRAMETINIB; INVESTIGATOR-CHOICE CHEMOTHERAPY; PRIMARY CUTANEOUS MELANOMA; AMERICAN JOINT COMMITTEE; TERT PROMOTER MUTATIONS; INDIVIDUAL PATIENT DATA; LYMPH-NODE DISSECTION; STAGE-III MELANOMA; HIGH-RISK MELANOMA; OPEN-LABEL;
D O I
10.1016/S0140-6736(18)31559-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cutaneous melanoma causes 55 500 deaths annually. The incidence and mortality rates of the disease differ widely across the globe depending on access to early detection and primary care. Once melanoma has spread, this type of cancer rapidly becomes life-threatening. For more than 40 years, few treatment options were available, and clinical trials during that time were all unsuccessful. Over the past 10 years, increased biological understanding and access to innovative therapeutic substances have transformed advanced melanoma into a new ontological model for treating solid cancers. Treatments that target B-Raf proto-oncogene serine/threonine-kinase (BRAF)(V600) (Val600) mutations using selected BRAF inhibitors combined with mitogen-activated protein kinase inhibitors have significantly improved response and overall survival. Furthermore, advanced cutaneous melanoma has developed into a prototype for testing checkpoint-modulating agents, which has increased hope for long-term tumour containment and a potential cure. These expectations have been sustained by clinical success with targeted agents and antibodies that block programmed cell-death protein 1 in locoregional disease, which induces prolongation of relapse-free, distant-metastasis-free, and overall survival times.
引用
收藏
页码:971 / 984
页数:14
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