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Review Article

葡萄膜黑色素瘤的免疫治疗-最新知识和观点

卷 27, 期 8, 2020

页: [1350 - 1366] 页: 17

弟呕挨: 10.2174/0929867326666190704141444

价格: $65

摘要

葡萄膜黑色素瘤是成人中最普遍的原发性眼内肿瘤，在美国和欧洲每百万人中有五至六例发病。葡萄膜黑色素瘤患者的预后不良，尽管放疗或手术切除的局部肿瘤治疗取得了重大进展，但其5年生存率仍为50-70％。从最初诊断开始，大约50％的患者会在15年内发生转移，大部分在肝脏。转移发生后的中位生存期为6个月。转移性葡萄膜黑色素瘤的潜在治疗选择是化学疗法，靶向疗法和免疫疗法，但没有方法显示令人满意的结果。具有检查点抑制作用的免疫疗法在皮肤黑色素瘤的治疗中显示出可喜的结果。但是，它对葡萄膜黑色素瘤似乎没有同样的疗效。这可能是由于突变负担不同，这两类肿瘤之间新抗原的表达，免疫抑制性肿瘤微环境以及葡萄膜黑色素瘤免疫原性和免疫特权低所致。考虑到在晚期葡萄膜黑色素瘤患者中使用抗CTLA-4和PD-1 / PD-L1阻滞剂治疗的效果令人失望，目前正在开发几种新的疗法。这可能包括使用IMCgp100，格伦巴单抗vedotin的免疫疗法和自体TIL的输注，使用选择性MEK抑制剂的靶向疗法，表观遗传疗法和纳米疗法。对葡萄膜黑色素瘤的分子和遗传特征的更好了解将有助于检测新的预后生物标志物，从而能够更好地修改现有的免疫治疗方法，并开发专门为葡萄膜黑色素瘤患者设计的新型治疗方法。

关键词: 葡萄膜黑色素瘤，转移，免疫疗法，检查点抑制，抗CTLA-4，抗PD-1 / PD-L1。

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