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Talimogene laherparepvec treatment to overcome loco-regional acquired resistance to immune checkpoint blockade in tumor stage IIIB-IV M1c melanoma patients.

Talimogene laherparepvec治疗克服肿瘤IIIB-IV期M1c黑色素瘤患者局部区域获得性免疫检查点阻滞耐药性。

  • 影响因子:4.40
  • DOI:10.1007/s00262-020-02487-x
  • 作者列表:"Fröhlich A","Niebel D","Fietz S","Egger E","Buchner A","Sirokay J","Landsberg J
  • 发表时间:2020-05-01
Abstract

BACKGROUND:Resistance to immune checkpoint blockade and targeted therapy in melanoma patients is currently one of the major clinical challenges. With the approval of talimogene laherparepvec (T-VEC), oncolytic viruses are now in clinical practice for locally advanced or non-resectable melanoma. Here, we describe the usage of T-VEC in stage IVM1b-M1c melanoma patients, who achieved complete remission or stable disease upon systemic treatment but suffered from a loco-regional recurrence. To our knowledge, there are no case reports so far describing T-VEC as a means to overcome acquired resistance to immune checkpoint blockade or targeted therapy. METHODS:All melanoma patients in our department treated with T-VEC in the period of 2016-2018 were evaluated retrospectively. Data on clinicopathological characteristics, treatment response, and toxicity were analyzed. RESULTS:Fourteen melanoma patients were treated with T-VEC in our center. Six patients (43%) received T-VEC first-line. In eight patients (57%), T-VEC followed a prior systemic therapy. Three patients with M1b stage and one patient with M1c stage melanoma were treated with T-VEC. These patients suffered from loco-regional progress, whilst distant metastases had regressed during prior systemic treatment. 64% of patients showed a benefit from therapy with T-VEC. The durable response rate was 36%. CONCLUSION:T-VEC represents an effective and tolerable treatment option. This is true not only for loco-regionally advanced melanoma patients, but also for patients with stable or regressive systemic metastases who develop loco-regionally acquired resistance upon treatment with immune checkpoint blockade or targeted therapy. A sensible selection of suitable patients seems to be crucial.

摘要

背景: 黑色素瘤患者对免疫检查点阻断和靶向治疗的抵抗是目前临床面临的主要挑战之一。随着talimogene laherparepvec (T-VEC) 的批准,溶瘤病毒现已用于局部晚期或不可切除的黑色素瘤的临床实践。在这里,我们描述了T-VEC在IVM1b-M1c期黑色素瘤患者中的使用情况,这些患者在全身治疗后获得完全缓解或疾病稳定,但患有局部复发。据我们所知,目前还没有病例报告描述T-VEC是克服获得性免疫检查点阻断或靶向治疗的手段。 方法: 对我科 2016 ~ 2018 例接受T-VEC治疗的黑色素瘤患者进行回顾性分析。分析了临床病理特征、治疗反应和毒性的数据。 结果: 本中心 14 例黑色素瘤患者接受了T-VEC治疗。6 例 (43%) 患者接受T-VEC一线治疗。在 8 例患者 (57%) 中,T-VEC遵循先前的全身治疗。3 例M1b期患者和 1 例M1c期黑色素瘤患者接受T-VEC治疗。这些患者出现局部进展,而远处转移在既往全身治疗期间消退。64% 的患者显示从T-VEC治疗中获益。持久应答率为 36%。 结论: T-VEC是一种有效且可耐受的治疗选择。这不仅适用于局部晚期黑色素瘤患者,也适用于稳定或退行性全身转移的患者,这些患者在接受免疫检查点阻断或靶向治疗后出现局部获得性耐药。合理选择合适的患者似乎至关重要。

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影响因子:2.93
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影响因子:0.96
发表时间:2020-01-01
DOI:10.1097/DAD.0000000000001459
作者列表:["Lang UE","Love NR","Cheung C","McCalmont TH","Kim J"]

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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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