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治疗IIB/IIC阶段黑色素瘤的辅助免疫疗法:目前的证据和未来的方向

Ivana Prkačin^1,2, Ana Brkić¹, Nives Pondeljak³

¹Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.

|August 28, 2025

概括

用PD- 1抑制剂进行辅助免疫治疗可以改善IIB/ IIC阶段黑色素瘤患者的无复发生存率. 然而,整体生存效益和毒性需要进一步研究以进行最佳的患者选择.

科学领域:

癌症学
免疫学
皮肤病学

背景情况:

切除的IIB和IIC阶段黑色素瘤患者在手术后面临高的复发和转移风险.
免疫检查点抑制剂 (ICI) 正在评估早期黑色素瘤的辅助治疗.

研究的目的:

对IIB/IIC阶段黑色素瘤的辅助免疫疗法的现有证据进行审查.
探索新兴的策略,挑战和辅助黑色素瘤治疗的未来方向.

主要方法:

临床试验,观察研究和生物标志物研究的综合文献综述.
对PD-1抑制剂试验 (KEYNOTE-716,CheckMate 76K),新疗法,耐药性机制,毒性和生物标志物进行了集中分析.

主要成果:

与安慰剂相比, pembrolizumab 和 nivolumab 显著改善了无复发存活率 (RFS) 和无远程转移存活率 (DMFS).
没有确定的整体生存益处;有免疫相关的不良事件,包括内分泌病变.
个性化的研究方法,如ctDNA监测和基因表达特征,可能有助于患者的选择.

结论:

在高危II期黑色素瘤中,辅助性PD-1阻断具有显著的RFS益处.
由于总体生存益处和毒性问题不确定,选择最佳患者是具有挑战性的.
未来的试验应整合基于生物标志物的策略,以改进治疗决策并减少过度治疗.

关键词:

PD-1 抑制剂辅助疗法生物标志物与免疫相关的不良事件免疫疗法黑色素瘤

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