Läsionale Therapieoptionen beim maligen Melanom

Leitthema

Zusammenfassung

Hintergrund

In den letzten Jahren kam es bezüglich der systemischen Therapie des metastasierten malignen Melanoms durch die Einführung der Immuncheckpointinhibitoren und die Möglichkeit der zielgerichteten Therapie mit BRAF- und MEK-Inhibitoren zu einer revolutionären Entwicklung. Problematisch können allerdings die Nebenwirkungen der Therapien sein, und zudem ist man noch weit davon entfernt, allen Patienten ein Benefit mit diesen Therapien zu bescheren. Viele Melanompatienten entwickeln im metastasierten Stadium kutane, subkutane oder Lymphknotenmetastasen, die einer lokalen oder intraläsionalen Therapie zugänglich sind.

Material und Methode

Diese Arbeit basiert auf einer selektiven Literaturrecherche in der Datenbank PubMed zum Thema „Läsionale Therapie beim malignen Melanom“.

Ergebnisse und Schlussfolgerung

Auch im Bereich der läsionalen Therapie des metatasierten malignen Melanoms konnten Fortschritte mit neuen Therapiestrategien erreicht werden. Von besonderem Interesse sind hier die oftmals aktuell in klinischen Studien getesteten Kombinationstherapien, die unter Umständen die Möglichkeit der Resistenzüberwindung gegenüber einer Checkpointinhibitor-Monotherapie ermöglichen.

Schlüsselwörter

Intraläsionale Therapie Kombinationstherapie BRAF- und MEK-Inhibitoren Intransitmetastasen Immuntherapie 

Lesional therapy options for malignant melanoma

Abstract

Background

In recent years the systemic therapy of metastasized melanoma was revolutionized by the introduction of immune checkpoint inhibitors for immunotherapy as well as BRAF and MEK inhibitors for targeted therapy. A problematic characteristic of these modern treatment options is the possible side effects. In addition, the approved modern therapeutic options do not elicit a response in every patient. There are many melanoma patients who develop cutaneous, subcutaneous or lymph node metastases that are accessible for local or intralesional therapy.

Methods

This review is based on a PubMed search of the medical subject heading terms “lesional therapy of malignant melanoma”.

Results and conclusion

Even in the sector of lesional therapy of metastasized malignant melanomas, remarkable progress has been achieved and new strategies have been developed. Of particular interest are the combination of local and systemic treatment, which is often currently tested in clinical trials, for overcoming resistance towards immune checkpoint inhibitors.

Keywords

Intralesional therapy Combination therapy BRAF and MEK inhibitors In transit metastases Immunotherapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

F. Kiecker gibt folgende Interessenskonflikte an: Beratungstätigkeiten (BMS, Amgen, MSD, Roche, Novartis, Incyte, Provectus). G. Poch G. Poch gibt folgende Interessenskonflikte an: Beratungstätigkeiten (Amgen). K. Farmer gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Dermatologie, Venerologie und AllergologieCharité Universitätsmedizin BerlinBerlinDeutschland

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