非黑色素瘤皮肤癌的主要治疗方法的指示和作用机制
Marcio F Chedid1,2, Aline C Tregnago3,4, Floriano Riva4
1Postgraduate Program in Medicine, Surgical Sciences and Oncological and Transplantation Surgery, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, Brazil.
Life (Basel, Switzerland)
|September 27, 2025
概括
皮肤癌治疗方法正在发展,手术成为标准. 像伊米基莫德和免疫疗法 (例如,塞米普利马布) 这样的新疗法对基底细胞癌和状细胞癌有前途,改善了结果并减少了复发.
科学领域:
- 皮肤病学和瘤学
- 免疫学和癌症生物学
背景情况:
- 皮肤癌,特别是基底细胞癌 (BCC) 和皮肤状细胞癌 (cSCC),在全球范围内普遍存在并日益增加.
- 包括莫斯微图外科手术 (MMS) 在内的外科治疗仍然是非黑色素瘤皮肤癌 (NMSC) 治疗的黄金标准,因为其治疗率很高.
- 新兴的治疗方法,如伊米基莫德和免疫疗法,为治疗皮肤癌提供了新的途径.
研究的目的:
- 审查目前和新兴的皮肤癌治疗方法,重点关注非黑色素瘤皮肤癌 (NMSCs) 和皮肤状细胞癌 (cSCC).
- 要突出伊米基莫德和诸如塞米普利马布之类的免疫疗法药物的作用机制.
- 讨论放射治疗 (RTh) 与手术和其他治疗一起发挥的作用.
主要方法:
- 审查已建立的治疗方法:传统手术和莫斯微图外科手术 (MMS).
- 对局部免疫反应修饰剂的分析:伊米基莫德及其通过托尔类受体 (TLR7/8) 的机制.
- 评估放射治疗 (RTh) 作为主要或辅助治疗.
- 评估新型免疫疗法:编程细胞死亡1 (PD-1) 阻断像塞米普利马布这样的抗体,包括最近的临床试验数据.
主要成果:
- 莫斯微图外科 (MMS) 为具有高治愈率的NMSC提供精确的边缘评估.
- 伊米基莫德调节免疫反应,具有直接的抗癌作用,已被批准用于表面BCC和行为性角质炎.
- 辐射疗法 (RTh) 在癌细胞中诱导DNA损伤和氧化应激.
- 塞米普利马布在cSCC的新辅助和辅助设置中显示出显著的疗效,减少瘤大小和复发风险.
结论:
- 虽然手术是标准的,但 imiquimod 和 RTh 为特定的皮肤癌提供了替代和辅助的选择.
- 免疫疗法,以塞米普利马布为例,在治疗晚期和高风险cSCC方面取得了重大进展,改善了器官的保存并减少了复发.
- 对这些不断发展的治疗策略的进一步研究对于优化皮肤癌管理至关重要.
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