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葡萄膜和结膜黑色素瘤的生物学特性及临床处理。

Biological characteristics and clinical management of uveal and conjunctival melanoma.

机构信息

School of Medicine, University of Zagreb, Zagreb, 10000, Croatia.

Department of Ophthalmology, Clinical Hospital Dubrava, Zagreb, 10000, Croatia.

出版信息

Oncol Res. 2024 Jul 17;32(8):1265-1285. doi: 10.32604/or.2024.048437. eCollection 2024.

Abstract

Uveal and conjunctival melanomas are relatively rare tumors; nonetheless, they pose a significant risk of mortality for a large number of affected individuals. The pathogenesis of melanoma at different sites is very similar, however, the prognosis for patients with ocular melanoma remains unfavourable, primarily due to its distinctive genetic profile and tumor microenvironment. Regardless of considerable advances in understanding the genetic characteristics and biological behaviour, the treatment of uveal and conjunctival melanoma remains a formidable challenge. To enhance the prospect of success, collaborative efforts involving medical professionals and researchers in the fields of ocular biology and oncology are essential. Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors. Despite advancements in the development of effective melanoma therapeutic strategies, all current treatments for uveal melanoma (UM) and conjunctival melanoma (CoM) remain unsatisfactory, resulting in a poor long-term prognosis. Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors. A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy, with various potential therapeutic targets currently under consideration. Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents, with the hope of improving the prognosis for patients with metastatic disease.

摘要

葡萄膜和结膜黑色素瘤是相对罕见的肿瘤;然而,它们为数以千计的受影响个体带来了重大的死亡风险。不同部位黑色素瘤的发病机制非常相似,然而,眼部黑色素瘤患者的预后仍然不佳,主要是由于其独特的遗传特征和肿瘤微环境。尽管在了解遗传特征和生物学行为方面取得了相当大的进展,但葡萄膜和结膜黑色素瘤的治疗仍然是一个巨大的挑战。为了提高成功的前景,涉及眼部生物学和肿瘤学领域的医学专业人员和研究人员的合作努力是必不可少的。目前的数据表明,这些肿瘤的治疗方法缺乏精心设计的随机临床试验,而且当前形式的治疗方法获益有限。尽管在开发有效的黑色素瘤治疗策略方面取得了进展,但所有目前用于治疗葡萄膜黑色素瘤(UM)和结膜黑色素瘤(CoM)的方法仍然不尽如人意,导致长期预后较差。正在进行的试验为晚期和转移性肿瘤的积极结果带来了希望。对眼部黑色素瘤发生和发展中涉及的遗传和分子异常的更全面了解为个性化治疗的发展开辟了道路,目前正在考虑各种潜在的治疗靶点。对 UM 和 CoM 的分子发病机制及其特异性的理解增加可能有助于开发新的、更有效的全身治疗药物,希望改善转移性疾病患者的预后。

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