Abstract
Advances in immune checkpoint and combination therapy have led to improvement in overall survival for patients with advanced melanoma. Improved understanding of the tumor, tumor microenvironment and tumor immune-evasion mechanisms has resulted in new approaches to targeting and harnessing the host immune response. Combination modalities with other immunotherapy agents, chemotherapy, radiotherapy, electrochemotherapy are also being explored to overcome resistance and to potentiate the immune response. In addition, novel approaches such as adoptive cell therapy, oncogenic viruses, vaccines and different strategies of drug administration including sequential, or combination treatment are being tested. Despite the progress in diagnosis of melanocytic lesions, correct classification of patients, selection of appropriate adjuvant and systemic theràapies, and prediction of response to therapy remain real challenges in melanoma. Improved understanding of the tumor microenvironment, tumor immunity and response to therapy has prompted extensive translational and clinical research in melanoma. There is a growing evidence that genomic and immune features of pre-treatment tumor biopsies may correlate with response in patients with melanoma and other cancers, but they have yet to be fully characterized and implemented clinically. Development of novel biomarker platforms may help to improve diagnostics and predictive accuracy for selection of patients for specific treatment. Overall, the future research efforts in melanoma therapeutics and translational research should focus on several aspects including: (a) developing robust biomarkers to predict efficacy of therapeutic modalities to guide clinical decision-making and optimize treatment regimens, (b) identifying mechanisms of therapeutic resistance to immune checkpoint inhibitors that are potentially actionable, (c) identifying biomarkers to predict therapy-induced adverse events, and (d) studying mechanism of actions of therapeutic agents and developing algorithms to optimize combination treatments. During the Melanoma Bridge meeting (December 2nd-4th, 2021, Naples, Italy) discussions focused on the currently approved systemic and local therapies for advanced melanoma and discussed novel biomarker strategies and advances in precision medicine as well as the impact of COVID-19 pandemic on management of melanoma patients.
Keywords: Adjuvant; Anti-CTLA-4; Anti-PD-1; BRAF inhibitor; Biomarkers; Combination strategies; Immunotherapy; MEK inhibitor; Melanoma; Neoadjuvant; Target therapy.
【저자키워드】 Biomarkers, Immunotherapy, Melanoma, adjuvant, target therapy., Anti-PD-1, MEK inhibitor, anti-CTLA-4, Neoadjuvant, Combination strategies, BRAF inhibitor, 【초록키워드】 viruses, Efficacy, Vaccine, immune response, therapy, Biomarker, COVID-19 pandemic, Diagnosis, combination therapy, Italy, immune, Chemotherapy, adverse events, survival, Host immune response, Accuracy, Radiotherapy, cancers, management, Algorithm, therapeutic, Research, Patient, Immune checkpoint inhibitor, combination treatment, target, therapeutic agent, development, genomic, mechanism of action, patients, predict, platform, mechanism, Evidence, Combination, BRAF, biopsy, Predictive, Precision, treatment regimens, lesions, help, effort, Drug administration, specific treatment, advance, Naples, tumor microenvironment, bridge, feature, Cell, robust, tumor immunity, tested, approach, addition, clinically, approved, characterized, overcome, Improved, translational, improve diagnostics, oncogenic, systemic and local, 【제목키워드】 Italy, bridge,