Keywords
melanoma
tratamento
How to Cite
Abstract
This article reviews recent advancements in the treatment of advanced and metastatic melanoma, focusing on immunotherapies, targeted therapies, and surgical approaches. Tebentafusp has demonstrated significant overall survival benefits in patients with metastatic uveal melanoma, especially among HLA-A*02:01-positive individuals, suggesting its potential as a first-line therapeutic option. Pembrolizumab, used as an adjuvant in early stages of resected melanoma, has proven effective in reducing the risk of distant metastasis and recurrence. The combination of ipilimumab and nivolumab has also shown high efficacy in treating brain metastases from melanoma, surpassing survival rates of conventional therapies. For rare melanomas, such as vaginal melanoma, surgery remains central, while immunotherapy is limited due to cost. Studies with encorafenib and binimetinib indicate durable benefits for patients with the BRAF mutation, and the use of microbiome biomarkers emerges as a promising area to optimize immunotherapy responses. This body of studies expands therapeutic options and proposes personalized strategies despite economic and access challenges.
References
DAVIS, L. E.; SHALIN, S. C.; TACKETT, A. J. Current state of melanoma diagnosis and treatment. Cancer Biology & Therapy, v. 20, n. 11, p. 1366–1379, 1 ago. 2019.
HASSEL, J. C. et al. Three-Year Overall Survival with Tebentafusp in Metastatic Uveal Melanoma. The New England Journal of Medicine, 21 out. 2023.
LUKE, J. J. et al. Pembrolizumab Versus Placebo as Adjuvant Therapy in Resected Stage IIB or IIC Melanoma: Final Analysis of Distant Metastasis-Free Survival in the Phase III KEYNOTE-716 Study. Journal of clinical oncology, v. 42, n. 14, p. 1619–1624, 10 maio 2024.
BELLUR, S. et al. Management of Brain Metastases: A Review of Novel Therapies. Seminars in Neurology, v. 43, n. 06, p. 845–858, 27 nov. 2023.
BAI, S. et al. Treatment of primary vaginal malignant melanoma and review of previous literature: A case report. Medicine, v. 102, n. 49, p. e36128–e36128, 8 dez. 2023.
WEBER, J. et al. Outcomes With Postrecurrence Systemic Therapy Following Adjuvant Checkpoint Inhibitor Treatment for Resected Melanoma in CheckMate 238. Journal of Clinical Oncology, 5 ago. 2024.
SCHADENDORF, D. et al. COLUMBUS 7-year update: a randomized, open-label, phase III trial of encorafenib plus binimetinib versus vemurafenib or encorafenib in patients with BRAF V600E/K-mutant melanoma. European Journal of Cancer, p. 114073–114073, 1 abr. 2024.
SCHADENDORF, D. et al. Pembrolizumab versus placebo as adjuvant therapy in resected stage IIB or IIC melanoma: Outcomes in histopathologic subgroups from the randomized, double-blind, phase 3 KEYNOTE-716 trial. Journal for ImmunoTherapy of Cancer, v. 12, n. 3, p. e007501–e007501, 1 mar. 2024.
PILATOS, J. M. et al. Overall Survival From Tebentafusp Versus Nivolumab Plus Ipilimumab in First Line Metastatic Uveal Melanoma: A Propensity Score Weighted Analysis. Annals of Oncology, 1 dez. 2023.
GLITZA, I. C. et al. Randomized Placebo-Controlled, Biomarker-Stratified Phase Ib Microbiome Modulation in Melanoma: Impact of Antibiotic Preconditioning on Microbiome and Immunity. Cancer discovery, p. OF1–OF15, 4 abr. 2024.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Igor do Rosário Costa, Gabriela Braga Rodrigues, Giovanna André Cardoso, Luiza Camapum Fernandes Ribeiro, Leonardo Pereira Levada, Giovanna Barros Monteiro, Sacha da Silva Faria, Ana Luiza Teles Taveira Moura, Brendha Castro Milazzo, Giovana Aires Paranhos, Isabela Valadão Amorim, Letícia Moreira Nery Moisés, Kauã José Rebetchuk Gewehr, Maria Stefenoni Thedoldi, Mariana Wal Mello, Marilia Wal Mello, Allison Renato Santos, Milena Beatriz Benício Neves, Rodrigo Daniel Zanoni