Poor Response to Checkpoint Immunotherapy in Uveal Melanoma Highlights the Persistent Need for Innovative Regional Therapy Approaches to Manage Liver Metastases.
Poor Response to Checkpoint Immunotherapy in Uveal Melanoma Highlights the Persistent Need for Innovative Regional Therapy Approaches to Manage Liver Metastases.
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DOI：
10.3390/cancers13143426
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发表时间：
2021-07-08
期刊：
影响因子：
5.2
通讯作者：
Boone BA
中科院分区：
文献类型：
--
作者：
Szeligo BM;Ivey AD;Boone BA
葡萄膜黑色素瘤是一种从眼睛中的黑色素细胞发展而来的癌症。这种疾病是非常罕见的，有很强的肝转移的倾向，其具有较差的长期预后，总生存期为6个月，1年死亡率为80%。免疫疗法和检查点抑制剂已经彻底改变了皮肤黑色素瘤的治疗，但在很大程度上被证明对葡萄膜黑色素瘤无效。与全身化疗和免疫治疗方法相关的不良反应，加上大多数转移性疾病孤立于肝脏的事实，表明持续需要区域治疗方法。在局部治疗中，肝脏灌注仍然与长达27个月的最佳生存结局相关。迫切需要针对葡萄膜黑色素瘤独特生物学的其他疗法。在这些治疗方法被开发和证实之前，隔离肝灌注仍然是一种可行的治疗选择。葡萄膜黑色素瘤是一种由后葡萄膜中的黑色素细胞发展而来的癌症。转移性葡萄膜黑色素瘤是一种极为罕见的疾病，其长期预后差，治疗选择有限，且易发生肝转移。据报道，中位总生存期为6个月，1年死亡率为80%。传统的化学疗法用于皮肤黑色素瘤是无效的葡萄膜案件。手术切除和消融是肝转移瘤的首选治疗方法，但由于疾病的程度，手术切除和消融往往不可行。在这篇综述中，我们将探讨葡萄膜黑色素瘤肝转移的治疗方案，重点是孤立的肝灌注（IHP）。IHP提供了一种积极的区域治疗方法，可用于体积庞大的不可切除的疾病，并允许高剂量的化疗与美法仑直接输送到肝脏，没有全身效应。据报道，长期中位总生存期高达27个月。我们还将强调与检查点抑制剂相关的不良反应，包括概述导致这种疾病缺乏免疫治疗效果的生物学原理。传统治疗和免疫治疗的持续失败表明，在这种疾病中持续需要区域手术方法，如IHP。
Uveal melanoma is a cancer that develops from melanocytes in the eye. This disease is extremely rare and has a strong predilection for liver metastasis, which has a poor long-term prognosis with overall survival of 6 months and 1 year mortality of 80%. Immunotherapy and checkpoint inhibitors have revolutionized treatment for cutaneous melanoma but have largely been proven to be ineffective in uveal melanoma. The poor response associated with systemic chemotherapy and immunotherapy approaches coupled with the fact that most metastatic disease is isolated to the liver suggests a persistent need for regional treatment approaches. Of regional therapies, hepatic perfusion continued to be associated with the best survival outcomes of up to 27 months. Additional therapies that target the unique biology of uveal melanoma are desperately needed. Until these treatments are developed and proven, isolated hepatic perfusion remains a viable treatment option. Uveal melanoma is a cancer that develops from melanocytes in the posterior uveal tract. Metastatic uveal melanoma is an extremely rare disease that has a poor long-term prognosis, limited treatment options and a strong predilection for liver metastasis. Median overall survival has been reported to be 6 months and 1 year mortality of 80%. Traditional chemotherapy used in cutaneous melanoma is ineffective in uveal cases. Surgical resection and ablation is the preferred therapy for liver metastasis but is often not feasible due to extent of disease. In this review, we will explore treatment options for liver metastases from uveal melanoma, with a focus on isolated hepatic perfusion (IHP). IHP offers an aggressive regional therapy approach that can be used in bulky unresectable disease and allows high-dose chemotherapy with melphalan to be delivered directly to the liver without systemic effects. Long-term median overall survival has been reported to be as high as 27 months. We will also highlight the poor responses associated with checkpoint inhibitors, including an overview of the biological rationale driving this lack of immunotherapy effect for this disease. The persistent failure of traditional treatments and immunotherapy suggest an ongoing need for regional surgical approaches such as IHP in this disease.
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DOI：
10.1158/1541-7786.mcr-17-0007
发表时间：
2017-05
期刊：
Molecular cancer research : MCR
影响因子：
--
作者：
Chua V;Lapadula D;Randolph C;Benovic JL;Wedegaertner PB;Aplin AE
通讯作者：
Aplin AE
影响因子：
1.8
作者：
Díaz-Coránguez M;Ramos C;Antonetti DA
通讯作者：
Antonetti DA
影响因子：
2.6
作者：
Boone, Brian A.;Bartlett, David L.;Zureikat, Amer H.
通讯作者：
Zureikat, Amer H.
影响因子：
8
作者：
Chen X;Wu Q;Tan L;Porter D;Jager MJ;Emery C;Bastian BC
通讯作者：
Bastian BC
影响因子：
2.5
作者：
Boone, Brian A.;Perkins, Samantha;Pingpank, James F.
通讯作者：
Pingpank, James F.