Developments in Intralesional Therapy for Metastatic Melanoma.
Developments in Intralesional Therapy for Metastatic Melanoma.
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DOI：
10.1177/107327481602300104
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
Zager JS
中科院分区：
文献类型：
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作者：
Sloot S;Rashid OM;Sarnaik AA;Zager JS
局部晚期黑色素瘤提出了复杂的临床挑战，需要采取多学科、以患者为中心的方法。在过去的几十年里，人们对许多药物作为病灶内治疗的适用性进行了研究，但很少有药物能够成功完成 3 期临床试验。搜索相关医学文献中有关转移性黑色素瘤病灶内治疗的文章。选择来自 2 期或更高阶段研究数据的疗法进行审查。本综述还总结了这些药物的作用机制、不良事件概况和临床数据。病灶内治疗在特定患者中显示出良好的效果，并且是当前晚期黑色素瘤治疗方案的宝贵财富。最佳方法应针对个体患者量身定制，包括病灶内治疗、区域灌注、全身免疫治疗、靶向治疗和/或手术的组合。由于相对较好的局部反应率和可耐受的不良事件，病灶内治疗可能是不可切除的局部晚期或转移性黑色素瘤患者的一种治疗选择。
Locoregional advanced melanoma poses a complex clinical challenge that requires a multidisciplinary, patient-centered approach. Numerous agents have been studied for their suitability as intralesional therapy in the past decades, but few have successfully completed phase 3 clinical trial testing. The relevant medical literature was searched for articles regarding use of intralesional therapies in metastatic melanoma. Therapies with data from phase 2 or higher studies were selected for review. This review also summarizes the mechanisms of action, adverse-event profiles, and clinical data for these agents. Intralesional therapies demonstrate promising effects in select patients and are a valuable asset to the current treatment options in advanced melanoma. The optimal approach should be tailored to the individual patient and consists of a combination of intralesional therapies, regional perfusions, systemic immunotherapies, targeted therapies and/or surgery. Due to relatively good local response rates and tolerable adverse-event profile, intralesional therapy may be a treatment option for patients with unresectable locally advanced or metastatic melanoma.