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用包括PD-1抑制剂在内的组合治疗转移性黑色素瘤的管理
Lara Valeska Maul1,2, Egle Ramelyte1,2, Reinhard Dummer1,2
1Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Expert opinion on biological therapy
|March 30, 2025
概括
免疫检查点抑制剂 (ICI) 已经改变了转移性黑色素瘤的治疗方法,为许多人提供了持久的控制. 组合有希望,但增加不良事件,需要生物标志物研究以进行个性化治疗.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 皮肤病学 皮肤病学
背景情况:
- 黑色素瘤是一种高度免疫的癌症.
- 免疫检查点抑制剂 (ICI) 显著提高了黑色素瘤的治疗效果.
- 在大约50%的转移性黑色素瘤患者中,使用抗CTLA4和抗PD-1抗体可以实现持久的癌症控制.
研究的目的:
- 批判性地审查目前关于ICI转移性黑色素瘤管理的数据.
- 探索基于ICI的黑色素瘤治疗的未来研究方向.
- 评估PD-1抑制剂组合的疗效和安全性.
主要方法:
- 在PubMed数据库的文献综述 (2024年11月 - 2025年3月).
- 专注于PD-1抑制剂组合的疗效和安全性.
- 分析临床试验数据和专家意见.
主要成果:
- 结合ICI可提高整体存活率10%左右,但增加不良事件.
- 抗LAG3/nivolumab的疗效与ipilimumab/nivolumab的疗效相当,但耐受性更好.
- 治疗决策因之前的新辅助/辅助疗法而复杂化.
结论:
- 建议Ipilimumab/nivolumab组合作为高风险转移性黑色素瘤的第一线治疗.
- 尼沃卢马布/雷拉利马布或PD-1单疗可能适用于较低风险的病例.
- 生物标志物的开发对于指导黑色素瘤个性化的ICI治疗策略至关重要.
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