systemic therapy of non-resectable metastatic melanoma系统性的切除治疗转移性黑素瘤.pdfVIP

Cancers 2010, 2, 955-969; doi:10.3390/cancers2020955 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review Systemic Therapy of Non-Resectable Metastatic Melanoma Azadeh Orouji, Sergij Goerdt and Jochen Utikal * Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; E-Mails: azadeh.orouji@umm.de (A.O.); sergij.goerdt@umm.de (S.G.) * Author to whom correspondence should be addressed; E-Mail: Jochen.Utikal@umm.de; Tel.: +49 621 383 4461; Fax: +49 621 383 3815. Received: 8 March 2010; in revised form: 11 May 2010 / Accepted: 12 May 2010 / Published: 26 May 2010 Abstract: In advanced metastatic melanoma (non-resectable stage III/IV), the prognosis still remains poor, with median survival times between six and twelve months. Systemic therapeutic approaches for metastatic melanoma include chemotherapy, immunotherapy, immunochemotherapy, small molecules and targeted therapy. In this review, we will focus on the various treatment modalities as well as new agents used for targeted therapy. Keywords: melanoma; metastatic; chemotherapy; targeted therapy; small molecules 1. Introduction Melanoma is an aggressive tumor with a continuously growing incidence worldwide. Depending on tumor thickness, ulceration and lymphocytic infiltration at the time of diagnosis, 20–25% of all primary melanoma will spread [1,2]. In case of distant metastatic melanoma, with the exception of rare cases of surgery for oligometastatic dis