Rothermel Luke D, Sarnaik Amod A, Khushalani Nikhil I, Sondak Vernon K
Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
Department of Cutaneous Oncology, Moffitt Cancer Center, 10920 N. McKinley Drive, Tampa, FL 33612, USA.
Surg Oncol Clin N Am. 2019 Jul;28(3):403-418. doi: 10.1016/j.soc.2019.02.001. Epub 2019 Apr 12.
Immunotherapy has revolutionized the treatment of melanoma, with implications for the surgical management of this disease. Surgeons must be aware of the impact of various immunotherapies on patients with resectable and unresectable disease, and how surgical decision-making should progress as a result. We expect that current and developing immunotherapies will increase surgeon involvement for resection of metastatic melanoma, whether for tumor harvests to generate autologous lymphocytes or for consolidating control of disease beyond what immunotherapies alone can achieve. Despite remarkable advancements in the field, significant work is needed to optimize the immuno-modulation that targets cancers while minimizing toxicity for patients.
免疫疗法彻底改变了黑色素瘤的治疗方式,对这种疾病的外科治疗产生了影响。外科医生必须了解各种免疫疗法对可切除和不可切除疾病患者的影响,以及外科决策应如何据此推进。我们预计,当前和正在研发的免疫疗法将增加外科医生对转移性黑色素瘤切除术的参与度,无论是为了获取肿瘤以产生自体淋巴细胞,还是为了巩固对疾病的控制,使其超出单纯免疫疗法所能达到的效果。尽管该领域取得了显著进展,但仍需要开展大量工作来优化针对癌症的免疫调节,同时将对患者的毒性降至最低。