Melanoma: Prognostic Factors and Factors Predictive of Response to Therapy

doi:10.2174/0929867326666191205160007
摘要

背景: 为了进一步提高黑色素瘤患者的生存率，需要更好地了解预测治疗反应的预后因素和生物标志物。预后因素: 影响黑素瘤预后的最重要的组织病理学因素是前哨淋巴结侵犯、肿瘤厚度增加、溃疡和较高的有丝分裂率。较差的生存率也可能与一些临床因素有关，包括性别、年龄、黑色素瘤的轴位、血清乳酸脱氢酶和S100B水平升高。可预测生物标记: 一些生物标志物已经被研究用来预测黑素瘤治疗的反应。对于抗程序死亡-1(PD-1)/程序性死亡配体1(PD-L1)检查点抑制剂，PD-L1肿瘤表达最初被认为对抗PD-1/PD-L1治疗有预测作用。然而，抗pd -1/PD-L1不表达的患者在抗pd -1/PD-L1治疗中也有生存优势，这意味着不能单独使用抗pd -1/PD-L1来选择患者进行治疗，以确认它可以被认为是一个相关的，而不是一个预测的标记。一系列其他因素显示与治疗结果相关，并为免疫治疗提供潜在的预测性生物标志物，包括免疫浸润、趋化因子标记和肿瘤突变负荷。然而，这些都没有被临床验证为患者选择的一个因素。对于联合靶向治疗(BRAF和MEK抑制)，乳酸脱氢酶水平和肿瘤负荷似乎对患者预后有影响。结论: 随着知识的增加，对黑色素瘤分期特异性预后特征的认识将进一步提高。此外，正在进行的试验应提供越来越多的证据，说明生物标记的最佳使用，以帮助选择最合适的患者进行免疫疗法和靶向疗法的量身定制治疗。
关键词: 生物标志物、BRAF抑制剂、免疫治疗、MEK抑制剂、黑色素瘤、PD-1、PD-L1、预后因子。
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DOI https://dx.doi.org/10.2174/0929867326666191205160007	Print ISSN 0929-8673
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