中国黑素瘤研究进展与新治疗策略

Research progress in and new treatment strategies for melanoma in China

尽管黑素瘤发病率正快速增长,但其在中国所占比例低,肿瘤科医生关注少。黑素瘤患者首诊科室主要是皮肤科,皮肤科医生能综合分析临床诊断、病理诊断、外科治疗和药物治疗,对黑素瘤的诊治具有独特优势。中国学者近年在黑素瘤的细胞死亡调控、表观遗传学修饰、靶向药物耐药、肿瘤微环境和肿瘤免疫调控等方面已获得很大进展。中国独有的一类新药干扰素α-1b不仅可用于Ⅱ、Ⅲ期高危黑素瘤的辅助治疗,对Ⅳ期黑素瘤也有很好的疗效,不良反应远低于干扰素α-2b。与白色人种不同,亚洲人皮肤黑素瘤以肢端型及黏膜型为主。以干扰素α-1b为基础制定联合治疗策略,探索其与程序性死亡受体-配体1抑制剂、靶向药物或血管生成抑制剂等的联合治疗方案,正在为挽救Ⅳ期黑素瘤患者带来希望。

Although the incidence of melanoma is increasing rapidly,its proportion is relatively low among all the malignant tumors in China,and oncologists commonly pay little attention.The first consultation place for melanoma patients is mainly the department of dermatology.Dermatologists have unique advantages in the diagnosis and treatment of melanoma since they can comprehensively integrate clinical diagnosis,pathological diagnosis,surgical treatment and drug treatment.In recent years,Chinese scholars have made great progress in melanoma research,such as regulation of cell death,epigenetic modification,resistance to targeted drugs,tumor microenvironment and tumor immune regulation.Interferonα-1b,a unique new drug in China,not only can be used for adjuvant treatment of high-risk stageⅡandⅢmelanoma,but also shows good efficacy in the treatment of stageⅣmelanoma,and adverse reactions to it are far less than those to interferonα-2b.Unlike the White population,the common subtypes of melanoma are acral and mucosal melanomas in the Asian population.The combination of interferonα-1b with programmed death receptor-ligand 1 inhibitor,targeted drugs or angiogenesis inhibitors is bringing hope for patients with stage IV melanoma.