皮肤癌的新辅助疗法:目前的证据和未来的前景
Lea Daniello1, Johannes Kleemann1, Bastian Schilling1
1Department of Dermatology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
概括
新辅助疗法,包括PD-1阻断和向治疗,正在彻底改变皮肤癌治疗. 这些方法通过减少复发和死亡率,显著改善了晚期状细胞癌,黑色素瘤和默克尔细胞癌的结果.
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:
- 免疫检查点抑制剂和向疗法已经改变了皮肤恶性瘤的治疗.
- 新辅助策略在局部发达的皮肤癌症中表现有前途.
研究的目的:
- 审查新辅助疗法在治疗晚期皮肤恶性瘤方面的疗效.
- 评估对病理反应率,复发率和死亡率的影响.
主要方法:
- 对新辅助剂PD-1阻断 (例如,塞米普利马布,尼沃卢马布) 和CTLA-4阻断的最近临床研究的综述.
- 针对黑色素瘤的BRAF-MEK抑制等向疗法的分析.
- 从第二期和第三期试验 (SWOG1801,NADINA) 的数据的评估.
主要成果:
- 新辅助剂PD-1阻断显示出高的病理反应率和减少状细胞癌的复发.
- 新辅助剂PD-1阻断,单独或与CTLA-4阻断相结合,显著降低黑色素瘤复发风险.
- 向疗法在BRAF突变黑色素瘤中是有效的.
- 新辅助性PD-1抑制剂在默克尔细胞癌中产生高响应率和有希望的生存率.
结论:
- 新辅助疗法为局部发达的皮肤瘤提供了显著的潜力.
- 这些方法减少了复发和死亡风险.
- 治疗降级的机会正在出现,例如省略辅助疗法.
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