新型组合性疗法或可有效治疗黑色素瘤患者

  来自加州大学戴维斯分校（UC Davis）的研究人员近日通过研究发现，一种新型的组合型疗法或可有效治疗患黑色素瘤的患者；文章中研究者发现，白介素-2（IL-2）结合咪喹莫特及维生素A类药物疗法或是治疗黑色素瘤及癌症转移患者的一种潜在疗法。
  相关研究发表于国际杂志the Journal of the American Academy of Dermatology上。研究者Maverakis博士表示，目前我们并不清楚是否有效控制内部黑色素瘤转移的靶向黑色素瘤疗法可以有效用于黑色素瘤转移的癌症患者；本文研究表明，结合可以促进免疫细胞分裂的蛋白的病灶内疗法结合局部应用的免疫激活剂或可用来有效治疗黑色素瘤转移的患者。尽管病灶内IL-2近来被美国国家综合癌症网络作为指导方针来有效管理患者皮肤内的黑色素瘤转移，但临床医生们并没有采用IL-2进行患者的治疗。
  大约有10%的患者会发生黑色素瘤皮肤内的恶性转移，传统来讲，治疗转移病灶的疗法通常是通过进行外科手术移除结合或不结合放疗进行治疗，但患者疾病的复发率往往较高。这项研究中研究人员对3期和4期黑色素瘤患者进行了一项回顾性分析，这些患者曾经都运用IL-2结合咪喹莫特及维生素A类药物疗法结合治疗，这些患者均在2006至2015年进行了皮肤学治疗服务，大部分为老年个体或其它疾病患者，11名患者中就有10人在手术治疗后疾病发生了复发，而且很多患者进行非外科手术的疗法依然失败了。
  研究数据显示，进行1-3个月的基于病灶内的IL-2疗法后，所有患者都产生了完全的临床反应；治疗2年后，82%的患者都存活着，而且有7名患者在黑色素瘤并没有复发的情况下生活良好，另外5名患者死于一些未知原因。最后研究者说道，研究结果非常鼓舞人心，而且本文研究表明，这种新型组合性的治疗策略对于改善黑色素瘤患者的生存非常关键。（转化医学网360zhyx.com）
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100% Complete response rate in patients with cutaneous metastatic melanoma treated with intralesional interleukin (IL)-2, imiquimod, and topical retinoid combination therapy: Results of a case series
JAAD DOI:10.1016/j.jaad.2015.06.060
Vivian Y. Shi, MD, Khiem Tran, PhD, Forum Patel, MD, Jonathan Leventhal, MD, Thomas Konia, MD, Maxwell A. Fung, MD, Reason Wilken, MD, Miki Shirakawa Garcia, MD, Sarah D. Fitzmaurice, MD, Jayne Joo, MD, Arta M. Monjazeb, MD, Barbara A. Burrall, MD, Brett King, MD, Steve Martinez, MD, Scott D. Christensen, MD, Emanual Maverakis, MD.
Background
Patients with cutaneous melanoma metastases have experienced excellent responses to intralesional interleukin (IL)-2. This has led to its recent inclusion into the US National Comprehensive Cancer Network guidelines for management of cutaneous melanoma metastases. Despite this, intralesional IL-2 has not been highlighted in the US literature nor have US physicians adopted it.
Objective
We sought to evaluate the effectiveness of intralesional IL-2 combined with topical imiquimod and retinoid for treatment of cutaneous metastatic melanoma.
Methods
A retrospective case series of 11 patients with cutaneous metastatic melanoma were treated with intralesional IL-2 combined with topical imiquimod and retinoid.
Results
A 100% complete local response rate with long-term follow-up (average of 24 months) was seen in all 11 patients treated with this proposed regimen. Biopsy specimens of treated sites confirmed absence of malignant cells. The most common treatment-related adverse event was rigors.
Limitations
Small number of patients, retrospective review of charts, and lack of a comparison group were limitations.
Conclusion
Intralesional IL-2 administered concomitantly with topical imiquimod and a retinoid cream is a promising therapeutic option for managing cutaneous melanoma metastases. The regimen was well tolerated and should be considered as a reasonable alternative to surgical excision.