头颈部黑色素瘤治疗现状及进展

Current status and development of head and neck melanoma treatments

头颈部是黑色素瘤好发的部位,约15%皮肤黑色素瘤和一半的黏膜黑色素瘤发生在头颈部区域。复发/转移的头颈部黑色素瘤对常规治疗不敏感,预后很差,一直是临床医师面临的巨大挑战。近年来,随着对黑色素瘤分子机制认识的不断深入,黑色素瘤的靶向治疗和免疫治疗取得了飞跃性的进展。在BRAF突变的黑色素瘤患者中,应用BRAF和MEK抑制剂可以取得很好的临床效果,而针对抗肿瘤免疫的单克隆抗体,通过阻断T细胞抑制受体发挥作用,也在临床上显现出抗黑色素瘤效果。

Melanomas are commonly found in the head and neck region, where 15% of cutaneous melanomas and approximately 50% of mucosal melanomas may occur. Recurrent or metastasized head and neck melanoma is resistant to standard treatments and thus a great challenge in oncology. Advances in the molecular pathogenesis of melanoma and in cancer immunology have led to the rational design and clinical implementation of various novel therapies for metastatic melanoma. For instance, BRAF and MEK inhibitors target the MAPK pathway, and these inhibitors exhibit high clinical response rates to BRAF-mutant melanoma. Specific therapies, including monoclonal antibodies that interfere with the pathways inhibiting T-cell functions, also modulate immune responses to melanoma; as such, these therapies have been applied to effectively treat melanoma.