肢端与黏膜黑色素瘤治疗研究进展  

Research progress in the treatment of acral and mucosal melanoma

作　　者：仇实 郭献灵 徐宇 陈勇 许青[2] Qiu Shi;Guo Xianling;Xu Yu;Chen Yong;Xu Qing(Department of Dermatology,Grossman School of Medicine,New York University,New York 10016,USA;Department of Oncology,Shanghai Tenth People′s Hospital,Tongji University School of Medicine,Shanghai,200072,China;Department of Musculoskeletal Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai,200032,China)

机构地区：[1]美国纽约大学格罗斯曼医学院皮肤科,纽约10016 [2]同济大学附属上海第十人民医院肿瘤科,上海200072 [3]复旦大学附属肿瘤医院骨软组织外科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华转移性肿瘤杂志》2024年第6期637-643,共7页Chinese Journal of Metastatic Cancer

基　　金：上海申康医院管理集团医企融合创新协同专项(SHDC2022CRT009);上海市科委中药创新与传承/中药新药临床前研究(21S21901500);上海市细胞治疗临床医学研究中心(23J41900100)。

摘　　要：中国人群中高发的肢端和黏膜黑色素瘤两种亚型,与欧美常见的皮肤型存在多方面差异,也因此在临床和病理分期系统上缺乏规范、统一、独立的标准。目前皮肤型黑色素瘤的标准治疗模式在肢端和黏膜两种亚型的应用范围和治疗效果也存在很大局限,世界范围内正积极开展创新疗法的临床试验,如组合PD-1抑制剂、抗血管生成治疗、细胞毒化疗等多种手段的联合治疗,以及探索NRAS、cKIT等突变位点的靶向疗法。近年来出现的一些创新型疗法,如T细胞治疗、双特异性T细胞衔接融合蛋白、抗体药物偶联物、个体化新抗原疫苗等,未来也有望应用于肢端和黏膜黑色素瘤。此外,新辅助疗法临床试验也将作为理想的药物开发平台,快速探索更为精准的肿瘤治疗策略,最终改善患者的生存。Acral and mucosal melanoma,the two histological subtypes that are prevalent among Chinese population,differ from cutaneous melanoma that is commonly seen in Europe and North America,in multiple aspects.As a result,there is still a lack of formalized,unified,and specific system of standards in clinical and pathological staging for these two subtypes.At present,the standard of care for cutaneous melanoma has displayed significant limitations in application range and treatment effectiveness when being applied to acral and mucosal melanoma subtypes.Innovative clinical trials are being actively conducted worldwide,including combination therapies with PD-1 inhibitors,anti-angiogenic treatments and cytotoxic chemotherapy,as well as exploration of targeted therapies for NRAS and cKIT mutations.Several novel therapeutic solutions that have emerged in recent years,such as T cell therapy(TCR-T and TIL),bispecific T cell engager fusion proteins,antibody-drug conjugates,and personalized neoantigen vaccines,are also expected to be applied to acral and mucosal melanoma treatment in the future.In addition,clinical trials on neoadjuvant therapy will serve as an ideal platform for drug development,aiming to explore more precise anti-tumor treatment strategies,eventually improving patient survival.

关 键 词：黑色素瘤 肢端 黏膜 诊断 治疗 

分 类 号：R73[医药卫生—肿瘤]