BRAF V600突变阳性的晚期黑色素瘤治疗的临床研究进展

doi:10.19401/j.cnki.1007-3639.2022.05.010

摘要/Abstract

摘要：

多数黑色素瘤具有BRAF V600E/K突变,因此V600成为黑色素瘤精准治疗的重要靶点,并通常可被BRAF抑制剂和MEK抑制剂联合阻断。免疫检查点抑制剂的出现也极大地改善了BRAF V600突变阳性的晚期黑色素瘤患者的治疗结局,探究这部分患者的最佳一线治疗及序贯治疗顺序的临床试验正在开展。本文就精准医疗时代BRAF V600突变阳性的晚期黑色素瘤患者治疗的最新研究进展进行综述。

关键词: BRAF V600突变, 晚期黑色素瘤, 免疫检查点抑制剂, BRAF抑制剂, MEK抑制剂

Abstract:

Most melanomas have BRAF V600E/K mutations, making V600 an important target for precision treatment of melanoma, and it can often be blocked by a combination of BRAF inhibitors and MEK inhibitors. The emergence of immune checkpoint inhibitors has also greatly improved the treatment outcome of patients with BRAF V600 mutation-positive advanced melanoma. Clinical trials are also underway to determine the best first-line treatment and the sequence of combination therapies for these patients. This paper reviewed the latest progress in the treatment of BRAF V600 mutation-positive advanced melanoma in the era of precision medicine.

Key words: BRAF V600 mutation, Advanced melanoma, Immune checkpoint inhibitors, BRAF inhibitors, MEK inhibitors

中图分类号:

R739.5

江健韵, 应红梅. BRAF V600突变阳性的晚期黑色素瘤治疗的临床研究进展[J]. 中国癌症杂志, 2022, 32(5): 445-450.

JIANG Jianyun, YING Hongmei. Clinical research progress in the treatment of BRAF V600 mutation-positive advanced melanoma[J]. China Oncology, 2022, 32(5): 445-450.

图/表 1

参考文献 45

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NCT number	Follow-up time t/year	Number of cases n	Intervention/treatment	Primary outcome	Intervention/treatment
coBRIM (NCT01689519)^[12]	≥5.0	495	Vemurafenib/cobimetinib vs vemurafenib	Median PFS: 12.6 months vs 7.2 months; 5-year PFS rate: 14% vs 10%	2019.07.21
CheckMate-067 (NCT01844505)^[8]	≥5.0	945	Nivolumab/ipilimumab vs nivolumab vs ipilimumab	Median OS: NR vs 45.5 months vs 24.6 months; 5-year OS rate: 60% vs 46% vs 30%	2016.08.01
IMspire-150 (NCT02908672)^[13]	2.0	514	Vemurafenib/cobimetinib/atezolizumab vs vemurafenib/cobimetinib	Median PFS: 15.1 months vs 10.6 months	2019.10.11
KEYNOTE-22 (NCT01597908)^[14]	3.0	563	Dabrafenib/trametinib/pembrolizumab vs dabrafenib/trametinib	Median PFS: 16.9 months vs 10.7 months; Median OS: NR vs 26.3 months	2019.04.25
COMBI-I (NCT02967692)^[15]	2.3	532	Dabrafenib/trametinib/spartalizumab vs dabrafenib/trametinib	Median PFS: 16.2 months vs 12.0 months	2020.08.11