Molecular Insights and Emerging Strategies for Treatment of Metastatic Uveal Melanoma.
Molecular Insights and Emerging Strategies for Treatment of Metastatic Uveal Melanoma.
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DOI：
10.3390/cancers12102761
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发表时间：
2020-09-25
期刊：
影响因子：
5.2
通讯作者：
Moramarco A
中科院分区：
文献类型：
--
作者：
Mallone F;Sacchetti M;Lambiase A;Moramarco A
大约50%的葡萄膜黑色素瘤（UM）患者仍会发展为转移性疾病。尽管最近在UM的诊断和预后方面取得了进展，但总体生存率并未得到改善。目前，对于辅助性和转移性情况，没有可用的护理标准。我们的回顾文章的目的是讨论了解葡萄膜黑色素瘤的分子机制和转移性疾病的新治疗方案的最新进展。我们对最近发表的文献以及一些正在进行的葡萄膜黑色素瘤辅助和转移治疗的临床试验进行了详细的分析。对UM发病机制的新认识和创新的定制治疗研究的有希望的结果可能为临床实践提供可行的机会。葡萄膜黑色素瘤是最常见的眼内癌。近几十年来，在UM的诊断和预后方面取得了重大进展，允许定制治疗。然而，近50%的患者仍然发展为转移性疾病，生存率不到1年。目前，UM的辅助治疗和转移治疗尚无标准，并且由于皮肤黑色素瘤的治疗方案，现有的治疗方法无效。包括肝脏定向治疗、免疫治疗和靶向治疗在内的先进治疗方案已经在um专门的单一化合物或联合治疗的临床试验中进行了研究，并取得了令人鼓舞的结果。旨在延长或靶向转移性肿瘤休眠的治疗方法在其他癌症中提供了令人鼓舞的结果，需要在UM中进行探索。本文就辅助性和转移性UM的诊断、预后和治疗的最新进展进行综述。此外，还讨论了肿瘤遗传学、生物学和免疫学方面的新见解，以及转移性休眠的机制。从本综述中讨论的众多研究中可以看出，对这种疾病的认识不断增加，以及新型个体化治疗试验的有希望的结果，可以为临床应用提供未来的前景。
Around 50% of patients with uveal melanoma (UM) still develop metastatic disease. Despite recent advances in the diagnosis and prognosis of UM, improvements in overall survival have not been achieved. At present, there is no available standard of care for adjuvant and metastatic settings. The aim of our review article was to discuss the latest advances in understanding the molecular mechanisms underlying uveal melanoma and novel treatment options for metastatic disease. We provided a detailed analysis of the most recently published works in the Literature along with a number of ongoing clinical trials for adjuvant and metastatic treatment of uveal melanoma. New insights into the pathogenesis of UM and promising results from the study of innovative tailored therapies could offer viable opportunities for translating in clinical practice. Uveal melanoma (UM) is the most common intraocular cancer. In recent decades, major advances have been achieved in the diagnosis and prognosis of UM allowing for tailored treatments. However, nearly 50% of patients still develop metastatic disease with survival rates of less than 1 year. There is currently no standard of adjuvant and metastatic treatment in UM, and available therapies are ineffective resulting from cutaneous melanoma protocols. Advances and novel treatment options including liver-directed therapies, immunotherapy, and targeted-therapy have been investigated in UM-dedicated clinical trials on single compounds or combinational therapies, with promising results. Therapies aimed at prolonging or targeting metastatic tumor dormancy provided encouraging results in other cancers, and need to be explored in UM. In this review, the latest progress in the diagnosis, prognosis, and treatment of UM in adjuvant and metastatic settings are discussed. In addition, novel insights into tumor genetics, biology and immunology, and the mechanisms underlying metastatic dormancy are discussed. As evident from the numerous studies discussed in this review, the increasing knowledge of this disease and the promising results from testing of novel individualized therapies could offer future perspectives for translating in clinical use.
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作者：
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