黑色素瘤治疗新进展

Recent Advances in Melanoma Treatment

黑色素瘤是皮肤癌中最致命的恶性肿瘤,可发生于黑色素细胞存在的任何解剖部位。由于恶性黑色素瘤的侵袭、迁移能力强,传统的放化疗治疗效果差。为了能够克服耐药并有效治疗黑色素瘤,亟需发现新的治疗因子(癌症相关的免疫检查点、信号通路、突变体等),将临床实施的各种治疗方案(手术治疗、辅助治疗、免疫治疗、靶向治疗、辐射治疗等)进行合理、安全、有效的组合。联合治疗手段不但能增强治疗效果,还可尽可能地避免耐药性的出现。纳米载药系统应用于肿瘤能够聚集于肿瘤部位释药,降低毒副作用,生物相容性良好,是一种良好的载药体系。本文介绍了黑色素瘤的形成、危险因素、预后、相关信号通路及纳米材料在黑色素瘤治疗中的应用,并着重介绍了目前黑色素瘤治疗的现状和新的研究方向。得出联合疗法在治疗黑色素瘤中显示出巨大潜力,且新的肿瘤相关因子对黑色素瘤的治疗也至关重要。

Melanoma is the deadliest malignancy in skin cancer and can occur at any anatomical site where melanocytes are present.Due to the invasion and migration ability of malignant melanoma,traditional chemoradiotherapy has a poor effect.In order to overcome drug resistance and effectively treat melanoma,it is urgent to discover new therapeutic factors(cancer-related immune checkpoints,signaling pathways,mutants,etc.),and various clinical treatment options(surgical treatment,adjuvant therapy,immunotherapy,targeted therapy,radiation therapy,etc.)are combined reasonably,safely and effectively.Combination therapy not only enhances the treatment effect,but also avoids the emergence of drug resistance as much as possible.The nano drug-loading system is able to accumulate in the tumor to release drugs and is associated with good biocompatibility,and hence reduces toxic and side effects.This article describes the formation,risk factors,prognosis and related signaling pathways of melanoma and the application of nanomaterials in the treatment of melanoma,highlighting the current status and new research directions of melanoma treatment.It concludes that combination therapy shows great potential and new tumor-associated factors are also crucial for the treatment of melanoma.