Management of intracranial melanomas in the era of precision medicine

被引:17
作者
Young, Grace J. [1 ]
Bi, Wenya Linda [1 ,2 ]
Wu, Winona W. [1 ]
Johanns, Tanner M. [3 ,4 ]
Dunn, Gavin P. [4 ,5 ]
Dunn, Ian F. [1 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Dept Neurosurg, Boston, MA 02115 USA
[2] Harvard Med Sch, Dana Farber Canc Inst, Dept Canc Biol, Boston, MA USA
[3] Washington Univ, Sch Med, Dept Internal Med, Div Med Oncol, St Louis, MO 63110 USA
[4] Washington Univ, Sch Med, Ctr Human Immunol & Immunotherapy Programs, St Louis, MO 63130 USA
[5] Washington Univ, Sch Med, Dept Neurol Surg, St Louis, MO 63130 USA
关键词
intracranial melanoma; BRAF inhibition; targeted therapy; immunotherapy; anti-PD1; WHOLE-BRAIN RADIOTHERAPY; RECOMBINANT INTERLEUKIN-2 THERAPY; LYMPHOCYTE-ASSOCIATED ANTIGEN-4; TUMOR-INFILTRATING LYMPHOCYTES; CANCER RESISTANCE PROTEIN; LONG-TERM SURVIVAL; METASTATIC MELANOMA; ACQUIRED-RESISTANCE; OPEN-LABEL; MALIGNANT-MELANOMA;
D O I
10.18632/oncotarget.19223
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Melanoma is the most lethal of skin cancers, in part because of its proclivity for rapid and distant metastasis. It is also potentially the most neurotropic cancer in terms of probability of CNS metastasis from the primary lesion. Despite surgical resection and radiotherapy, prognosis remains guarded for patients with brain metastases. Over the past five years, a new domain of personalized therapy has emerged for advanced melanoma patients with the introduction of BRAF and other MAP kinase pathway inhibitors, immunotherapy, and combinatory therapeutic strategies. By targeting critical cellular signaling pathways and unleashing the adaptive immune response against tumor antigens, a subset of melanoma patients have demonstrated remarkable responses to these treatments. Over time, acquired resistance to these modalities inexorably develops, providing new challenges to overcome. We review the rapidly evolving terrain for intracranial melanoma treatment, address likely and potential mechanisms of resistance, as well as evaluate promising future therapeutic approaches currently under clinical investigation.
引用
收藏
页码:89326 / 89347
页数:22
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