摘要
Увеальная меланома редкая внутриглазная опухоль, несмотря на все успехи в лечении первичной опухоли, более чем у 50 % пациентов развивается метастатическая форма заболевания. Увеальная меланома отличается по своим молекулярно-биологическим особенностям (другие драйверные мутации, меньшая мутационная нагрузка) от меланомы кожи, и если для меланомы кожи достигнуты определённые успехи в лечении (таргетная терапия, иммунотерапия), то для увеальной меланомы продолжаются поиски новых мишеней и подходов. В статье приведены исследования, отражающие эффективность и безопасность основных системных и локальных методов лечения, а также набирающих в последнее время популярность комбинированных подходов в лечении метастатической увеальной меланомы.
参考
Spagnolo F., Caltabiano G., Queirolo P. Uveal melanoma. Cancer Treat Rev. 2012; 38(5): 549-53.-DOI: https://doi.org/10.1016/j.ctrv.2012.01.002.-URL: https://www.cancertreatmentreviews.com/article/S0305-7372(12)00003-5/fulltext.
Virgili G., Gatta G., Ciccolallo L., et al. Incidence of uveal melanoma in Europe. Ophthalmology. 2007; 114(12): 2309-2315.e2.-DOI: https://doi.org/10.1016/j.ophtha.2007.01.032.-URL: https://www.aaojournal.org/article/S0161-6420(07)00176-5/fulltext.
Smit K.N., Jager M.J., de Klein A., Kiliҫ E. Uveal melanoma: Towards a molecular understanding. Prog Retin Eye Res. 2020; 75: 100800.-DOI: https://doi.org/10.1016/j.preteyeres.2019.100800.-URL: https://www.sciencedirect.com/science/article/abs/pii/S1350946219300874?via%3Dihub.
Rietschel P., Panageas K.S., Hanlon C., et al. Variates of survival in metastatic uveal melanoma. J Clin Oncol. 2005; 23(31): 8076-80.-DOI: https://doi.org/10.1200/JCO.2005.02.6534-URL: https://ascopubs.org/doi/10.1200/JCO.2005.02.6534.
Silva-Rodríguez P., Fernández-Díaz D., Bande M., et al. GNAQ and GNA11 genes: a comprehensive review on oncogenesis, prognosis and therapeutic opportunities in uveal melanoma. Cancers (Basel). 2022; 14(13): 3066.-DOI: https://doi.org/10.3390/cancers14133066.-URL: https://www.mdpi.com/2072-6694/14/13/3066.
Griewank K.G., van de Nes J., Schilling B., et al. Genetic and clinico-pathologic analysis of metastatic uveal melanoma. Modern Pathology. 2014; 27(2): 175-83.-DOI: https://doi.org/10.1038/modpathol.2013.138.-URL: https://www.modernpathology.org/article/S0893-3952(22)01807-5/fulltext.
Couturier J., Saule S. Genetic determinants of uveal melanoma. Dev Ophthalmol. 2012: 150-65.-DOI: https://doi.org/10.1159/000328270.-URL: https://pubmed.ncbi.nlm.nih.gov/22042019/.
Furney S.J., Pedersen M., Gentien D., et al. SF3B1 Mutations Are Associated with Alternative Splicing in Uveal Melanoma. Cancer Discov. 2013; 3(10): 1122-9.-DOI: https://doi.org/10.1158/2159-8290.CD-13-0330.-URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321577/.
Rao R.D., Holtan S.G., Ingle J.N., et al. Combination of paclitaxel and carboplatin as second‐line therapy for patients with metastatic melanoma. Cancer. 2006; 106(2): 375-82.-DOI: https://doi.org/10.1002/cncr.21611.-URL: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.21611.
Pföhler C., Cree I.A., Ugurel S., et al. Treosulfan and gemcitabine in metastatic uveal melanoma patients: results of a multicenter feasibility study. Anticancer Drugs. 2003; 14(5): 337-40.-DOI: https://doi.org/10.1097/00001813-200306000-00002.-URL: https://journals.lww.com/anti-cancerdrugs/abstract/2003/06000/treosulfan_and_gemcitabine_in_metastatic_uveal.2.aspx.
Bol K.F., Ellebaek E., Hoejberg L., et al. Real-world impact of immune checkpoint inhibitors in metastatic uveal melanoma. Cancers (Basel). 2019; 11(10): 1489.-DOI: https://doi.org/10.3390/cancers11101489.-URL: https://www.mdpi.com/2072-6694/11/10/1489.
Piulats J.M., Espinosa E., de la Cruz Merino L., et al. Nivolumab plus ipilimumab for treatment-naïve metastatic uveal melanoma: an open-label, multicenter, phase II trial by the Spanish Multidisciplinary Melanoma Group (GEM-1402). J Clin Oncol. 2021; 39(6): 586-98.-DOI: https://doi.org/10.1200/JCO.20.00550.-URL: https://ascopubs.org/doi/10.1200/JCO.20.00550.
Pelster M.S., Gruschkus S.K., Bassett R., et al. Nivolumab and ipilimumab in metastatic uveal melanoma: results from a single-arm phase II study. J Clin Oncol. 2021; 39(6): 599-607.-DOI: https://doi.org/10.1200/JCO.20.00605.-URL: https://ascopubs.org/doi/10.1200/JCO.20.00605.
Khan S., Carvajal R.D. Dual immunological checkpoint blockade for uveal melanoma. J Clin Oncol. 2021; 39(6): 554-6.-DOI: https://doi.org/10.1200/JCO.20.03274.-URL: https://ascopubs.org/doi/10.1200/JCO.20.03274.
Назарова В.В., Орлова К.В., Утяшев И.А., et al. Комбинированная иммунотерапия при метастатической увеальной меланоме. Опыт одного центра. Эффективная фармакотерапия. 2023; 19 (16): 64-71.-DOI: https://doi.org/10.33978/2307-3586-2023-19-16-64-71.-URL: https://umedp.ru/articles/kombinirovannaya_immunoterapiya_pri_metastaticheskoy_uvealnoy_melanome_opyt_odnogo_tsentra.html. [Nazarova V.V., Orlova K.V., Utyashev I.A., et al. Combined immunotherapy for metastatic uveal melanoma. Single centre experience. Effective Pharmacotherapy. 2023; 19 (16): 64-71. -DOI: https://doi.org/10.33978/2307-3586-2023-19-16-64-71.-URL: https://umedp.ru/articles/kombinirovannaya_immunoterapiya_pri_metastaticheskoy_uvealnoy_melanome_opyt_odnogo_tsentra.html. (In Rus)].
Shao Y.F., Baca Y., Xiu J., et al. Immune profiling of metastatic uveal melanoma and response to immune checkpoint inhibitors. J Clin Oncol. 2022; 40(16_suppl): 9565-9565.-DOI: https://doi.org/10.1200/JCO.2022.40.16_suppl.9565.-URL: https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.9565.
Ny L., Jespersen H., Karlsson J., et al. The PEMDAC phase 2 study of pembrolizumab and entinostat in patients with metastatic uveal melanoma. Nat Commun. 2021; 12(1): 5155.DOI: https://doi.org/10.1038/s41467-021-25332-w.-URL: https://www.nature.com/articles/s41467-021-25332-w.
Algazi A.P., Tsai K.K., Shoushtari A.N., et al. Clinical outcomes in metastatic uveal melanoma treated with PD‐1 and PD‐L1 antibodies. Cancer. 2016; 122(21): 3344-53.-DOI: https://doi.org/10.1002/cncr.30258.-URL: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.30258.
Nathan P., Hassel J.C., Rutkowski P., et al. Overall survival benefit with tebentafusp in metastatic uveal melanoma. N Engl J Med. 2021; 385(13): 1196-206.-DOI: https://doi.org/10.1056/NEJMoa2103485.-URL: https://www.nejm.org/doi/10.1056/NEJMoa2103485.
Croce M., Ferrini S., Pfeffer U., Gangemi R. Targeted therapy of uveal melanoma: recent failures and new perspectives. Cancers (Basel). 2019; 11(6): 846.-DOI: https://doi.org/10.3390/cancers11060846.-URL: https://www.mdpi.com/2072-6694/11/6/846.
Falchook G.S., Lewis K.D., Infante J.R., et al. Activity of the oral MEK inhibitor trametinib in patients with advanced melanoma: a phase 1 dose-escalation trial. Lancet Oncol. 2012; 13(8): 782-9.-DOI: https://doi.org/10.1016/S1470-2045(12)70269-3.-URL: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70269-3/fulltext.
Carvajal R.D., Piperno-Neumann S., Kapiteijn E., et al. Selumetinib in combination with dacarbazine in patients with metastatic uveal melanoma: a phase III, multicenter, randomized trial (SUMIT). J Clin Oncol. 2018; 36(12): 1232-9.-DOI: https://doi.org/10.1200/JCO.2017.74.1090.-URL: https://ascopubs.org/doi/10.1200/JCO.2017.74.1090.
Cao L., Chen S., Sun R., et al. Darovasertib, a novel treatment for metastatic uveal melanoma. Front Pharmacol. 2023; 14.-DOI: https://doi.org/10.3389/fphar.2023.1232787.-URL: https://www.frontiersin.org/articles/10.3389/fphar.2023.1232787/full.
Hameed A.M., Ng E.E.I., Johnston E., et al. Hepatic resection for metastatic melanoma. Melanoma Res. 2014; 24(1): 1-10.-DOI: https://doi.org/10.1097/CMR.0000000000000032.-URL: https://journals.lww.com/melanomaresearch/abstract/2014/02000/hepatic_resection_for_metastatic_melanoma__a.1.aspx.
Sato T. Locoregional Management of Hepatic Metastasis From Primary Uveal Melanoma. Semin Oncol. 2010; 37(2): 127-38.-DOI: https://doi.org/10.1053/j.seminoncol.2010.03.014.-URL: https://www.sciencedirect.com/science/article/abs/pii/S0093775410000382.
Каприн А.Д., Иванов С.А., Петров Л.О., et al. Трансартериальная химиоэмболизация и изолированная химиоперфузия печени в лечении больных увеальной меланомой при метастатическом поражении печени (систематический обзор). Медицинские технологии. Оценка и выбор. 2022;44(2):72‑79.- DOI: https://doi.org/10.17116/medtech20224402172.-URL: https://www.mediasphera.ru/issues/meditsinskie-tekhnologii-otsenka-i-vybor/2022/2/1221906782022021072. [Kaprin A.D., Ivanov S.A., Petrov L.O., et al. Transarterial chemoembolization and isolated liver chemoperfusion in the treatment of uveal melanoma in patients with liver metastases (a systematic review). Medical Technologies Assessment and Choice. 2022; 44(2): 72.- DOI: https://doi.org/10.17116/medtech20224402172.-URL: https://www.mediasphera.ru/issues/meditsinskie-tekhnologii-otsenka-i-vybor/2022/2/1221906782022021072. (In Rus)].
Olofsson Bagge R., Nelson A., Shafazand A., et al. Isolated hepatic perfusion with melphalan for patients with isolated uveal melanoma liver metastases: a multicenter, randomized, open-label, phase III trial (the SCANDIUM Trial). J Clin Oncol. 2023; 41(16): 3042-50.-DOI: https://doi.org/10.1200/JCO.22.01705.-URL: https://ascopubs.org/doi/10.1200/JCO.22.01705.
Zager J.S., Orloff M.M., Ferrucci P.F., et al. FOCUS phase 3 trial results: Percutaneous hepatic perfusion (PHP) with melphalan for patients with ocular melanoma liver metastases (PHP-OCM-301/301A). J Clin Oncol. 2022; 40(16_suppl): 9510-9510.-DOI: https://doi.org/10.1200/JCO.2022.40.16_suppl.9510.-URL: https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.9510.
Магомедова З.Р., Назарова В.В., Орлова К.В., et al. Комбинированный подход в лечении больных метастатической увеальной меланомы. Тезисы постерных докладов и принятые к публикации. Злокачественные опухоли. 2023; 13(3s1): 112-113.-URL: https://www.malignanttumors.org/jour/article/view/1194. [Magomedova Z.R., Nazarova V.V., Orlova K.V., et al. Combined approach for treatment of patients with metastatic uveal melanoma. Malignant Tumours. 2023; 13(3s1): 112-113.-URL: https://www.malignanttumors.org/jour/article/view/1194. (In Rus)].
Grynberg S., Stoff R., Asher N., et al. Radiotherapy may augment response to immunotherapy in metastatic uveal melanoma patients. Ther Adv Med Oncol. 2022; 14: 175883592211315.-DOI: https://doi.org/10.1177/17588359221131521.-URL: https://journals.sagepub.com/doi/10.1177/17588359221131521.
Rossi E., Cellini F., Pagliara M.M., et al. Hepatic radiotherapy in addition to anti-PD-1 for the treatment of metastatic uveal melanoma patients. Cancers (Basel). 2023; 15(2): 493.-DOI: https://doi.org/10.3390/cancers15020493.-URL: https://www.mdpi.com/2072-6694/15/2/493.
Olofsson Bagge R., Nelson A., Shafazand A., et al. A phase I, randomized, controlled, multicentre trial of isolated hepatic perfusion in combination with ipilimumab and nivolumab in patients with uveal melanoma metastases (the SCANDIUM 2 trial). J Clin Oncol. 2023; 41(16_suppl): 9533-9533.-DOI: https://doi.org/10.1200/JCO.2023.41.16_suppl.9533.-URL: https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.9533.
Tong T.M.L., Burgmans M.C., Speetjens F.M., et al. Combining melphalan percutaneous hepatic perfusion with ipilimumab plus nivolumab in advanced uveal melanoma: first safety and efficacy data from the phase Ib part of the chopin trial. Cardiovasc Intervent Radiol. 2023; 46(3): 350-9.-DOI: https://doi.org/10.1007/s00270-022-03338-1.-URL: https://pubmed.ncbi.nlm.nih.gov/36624292/.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2024