Abstract：
To provide guidance to clinicians regarding the use of systemic therapy for melanoma.
American Society of Clinical Oncology convened an Expert Panel and conducted an updated systematic review of the literature.
The updated review identified 21 additional randomized trials.
Neoadjuvant pembrolizumab was newly recommended for patients with resectable stage IIIB to IV cutaneous melanoma. For patients with resected cutaneous melanoma, adjuvant nivolumab or pembrolizumab was newly recommended for stage IIB-C disease and adjuvant nivolumab plus ipilimumab was added as a potential option for stage IV disease. For patients with unresectable or metastatic cutaneous melanoma, nivolumab plus relatlimab was added as a potential option regardless of BRAF mutation status and nivolumab plus ipilimumab followed by nivolumab was preferred over BRAF/MEK inhibitor therapy. Talimogene laherparepvec is no longer recommended as an option for patients with BRAF wild-type disease who have progressed on anti-PD-1 therapy. Ipilimumab- and ipilimumab-containing regimens are no longer recommended for patients with BRAF-mutated disease after progression on other therapies.This full update incorporates the new recommendations for uveal melanoma published in the 2022 Rapid Recommendation Update.Additional information is available at www.asco.org/melanoma-guidelines.
American Society of Clinical Oncology convened an Expert Panel and conducted an updated systematic review of the literature.
The updated review identified 21 additional randomized trials.
Neoadjuvant pembrolizumab was newly recommended for patients with resectable stage IIIB to IV cutaneous melanoma. For patients with resected cutaneous melanoma, adjuvant nivolumab or pembrolizumab was newly recommended for stage IIB-C disease and adjuvant nivolumab plus ipilimumab was added as a potential option for stage IV disease. For patients with unresectable or metastatic cutaneous melanoma, nivolumab plus relatlimab was added as a potential option regardless of BRAF mutation status and nivolumab plus ipilimumab followed by nivolumab was preferred over BRAF/MEK inhibitor therapy. Talimogene laherparepvec is no longer recommended as an option for patients with BRAF wild-type disease who have progressed on anti-PD-1 therapy. Ipilimumab- and ipilimumab-containing regimens are no longer recommended for patients with BRAF-mutated disease after progression on other therapies.This full update incorporates the new recommendations for uveal melanoma published in the 2022 Rapid Recommendation Update.Additional information is available at www.asco.org/melanoma-guidelines.
摘要：
目的：为临床医生提供黑色素瘤全身治疗的指导。
方法：美国临床肿瘤学会召集了一个专家小组，并对文献进行了最新的系统综述。
结果：更新的综述确定了另外21项随机试验。
■新辅助派姆单抗被推荐用于可切除的IIIB期至IV期皮肤黑色素瘤患者。对于切除皮肤黑色素瘤的患者，Nivolumab或pembrolizumab是新推荐用于IIB-C期疾病的辅助治疗方案,Nivolumab联合ipilimumab是IV期疾病的潜在选择.对于不可切除或转移性皮肤黑色素瘤患者，无论BRAF突变状态如何,nivolumab+relatlimab均被添加为潜在选择,nivolumab+ipilimumab和nivolumab比BRAF/MEK抑制剂疗法更优先.Talimogenelaherparepvec不再被推荐作为抗PD-1治疗进展的BRAF野生型疾病患者的选择。在其他疗法进展后，不再推荐含有伊匹单抗和伊匹单抗的方案用于BRAF突变疾病的患者。此完整更新纳入了2022年快速建议更新中发布的针对葡萄膜黑色素瘤的新建议。其他信息可在www上获得。asco.org/黑色素瘤指南。
方法：美国临床肿瘤学会召集了一个专家小组，并对文献进行了最新的系统综述。
结果：更新的综述确定了另外21项随机试验。
■新辅助派姆单抗被推荐用于可切除的IIIB期至IV期皮肤黑色素瘤患者。对于切除皮肤黑色素瘤的患者，Nivolumab或pembrolizumab是新推荐用于IIB-C期疾病的辅助治疗方案,Nivolumab联合ipilimumab是IV期疾病的潜在选择.对于不可切除或转移性皮肤黑色素瘤患者，无论BRAF突变状态如何,nivolumab+relatlimab均被添加为潜在选择,nivolumab+ipilimumab和nivolumab比BRAF/MEK抑制剂疗法更优先.Talimogenelaherparepvec不再被推荐作为抗PD-1治疗进展的BRAF野生型疾病患者的选择。在其他疗法进展后，不再推荐含有伊匹单抗和伊匹单抗的方案用于BRAF突变疾病的患者。此完整更新纳入了2022年快速建议更新中发布的针对葡萄膜黑色素瘤的新建议。其他信息可在www上获得。asco.org/黑色素瘤指南。
