皮肤黑色素瘤的管理,特别关注表皮性黑色素瘤
Kari L Kendra1, Carlo M Contreras2, Claire F Verschraegen1
1Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH.
概括
作为一种罕见的乳腺癌亚型的desmoplastic黑色素瘤 (DM),对PD1阻断疗法的反应显著. 这种免疫疗法提供了持久的生存率,并影响了可切除和不可切除病例的治疗策略.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫治疗是一种免疫疗法.
背景情况:
- 肌性黑色素瘤 (DM) 是一种罕见的皮肤黑色素瘤的黑色素瘤亚型.
- DM的特征是状细胞,密集的纤维状基质和频繁的NF1突变.
- 不同于常见的黑色素瘤,DM由于其黑色素质的性质,经常被误认为是良性病变.
研究的目的:
- 为了回顾脱质黑色素瘤的独特特征.
- 评估PD1阻断在治疗DM中的有效性.
- 为无法切除的,切除的和高风险的DM提供治疗指南.
主要方法:
- 对DM患者的临床数据和治疗结果的审查.
- 对单剂PD1阻断 (pembrolizumab) 的反应率和生存数据的分析.
- 在DM管理中评估新辅助疗法,哨兵淋巴结活检和辅助辐射.
主要成果:
- 黑色素瘤对单剂PD1阻断表现出极高的敏感性,具有96%的黑色素瘤特异性3年生存率.
- 对于不可切除的DM,一线PD1阻塞显示了89%的整体反应率.
- 新辅助药布罗利祖马布实现了57%的病理完整反应率;对于纯粹的DM,哨兵淋巴结活检被认为是不必要的.
结论:
- 单剂PD1阻断是一种高效的第一线治疗脱质黑色素瘤.
- 新辅助性PD1阻断显示出可切除DM的前景.
- 治疗降级,例如省略哨兵淋巴结活检,对于纯粹的DM是适当的,反映了"更少更好"的方法.
相关概念视频
01:30Skin Cancer
4.0K
Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
4.0K
01:14Changes in Skin Color: Clinical Perspectives
1.8K
The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
1.8K
01:23Skin Diseases and Disorders
3.7K
Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
3.7K