Skip to main content
Log in

Therapie des inoperabel metastasierten Melanoms

Treatment of advanced metastatic melanoma

  • Leitthema
  • Published:
Der Hautarzt Aims and scope Submit manuscript

Zusammenfassung

In der Vergangenheit war die Therapie des fortgeschrittenen Melanoms im Stadium der Fernmetastasierung von einem oft nur limitierten Erfolg gekennzeichnet. Die in den letzten Jahren gewonnenen Erkenntnisse zur Pathogenese und Immunologie des Melanoms ermöglichten die Entwicklung neuer vielversprechender Therapieansätze für bestimmte Gruppen von Melanompatienten. In der vorliegenden Arbeit werden neben diesen molekular gerichteten und immunmodulierenden Therapien auch bereits länger etablierte Therapien wie die Strahlen- oder Chemotherapie diskutiert.

Abstract

In the past therapy of advanced melanoma with distant metastases was characterized by limited success. In recent years the increased understanding of the pathogenesis of melanoma as well as tumor immunology, however, has allowed the development of new promising therapeutic options for certain subgroups of melanoma patients. In the present review these molecular-targeted and immune-modulating therapies, as well as already established therapies such as radiation or chemotherapy, will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1

Literatur

  1. Balch CM, Gershenwald JE et al (2009) Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 27(36):6199–6206

    Article  PubMed  Google Scholar 

  2. Bedikian AY, Johnson MM et al (2008) Systemic therapy for unresectable metastatic melanoma: impact of biochemotherapy on long-term survival. J Immunotoxicol 5(2):201–207

    Article  PubMed  CAS  Google Scholar 

  3. Brown PD, Brown C A et al (2002) Stereotactic radiosurgery for patients with radioresistant brain metastases. Neurosurgery 51(3):656–665

    PubMed  Google Scholar 

  4. Buchsbaum JC, Suh JH et al (2002) Survival by radiation therapy oncology group recursive partitioning analysis class and treatment modality in patients with brain metastases from malignant melanoma: a retrospective study. Cancer 94(8):2265–2272

    Article  PubMed  Google Scholar 

  5. Carter SK, Friedman MA (1972) 5-(3,3-dimethyl-l-triazeno)-imidazole-4-carboxamide (DTIC, DIC, NSC-45388) – a new antitumor agent with activity against malignant melanoma. Eur J Cancer 8(1):85–92

    PubMed  CAS  Google Scholar 

  6. Chang EL, Wefel JS et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037–1044

    Article  PubMed  Google Scholar 

  7. Curtin JA, Busam K et al (2006) Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol 24:4340–4346

    Article  PubMed  CAS  Google Scholar 

  8. Eigentler TK, Caroli UM et al (2003) Palliative therapy of disseminated malignant melanoma: a systematic review of 41 randomised clinical trials. Lancet Oncol 4(12):748–759

    Article  PubMed  CAS  Google Scholar 

  9. Flaherty KT, Puzanov I et al (2010) Inhibition of mutated, activated BRAF in metastatic melanoma. N Engl J Med 363(9):809–819

    Article  PubMed  CAS  Google Scholar 

  10. Gerstner ER, Fine RL (2007) Increased permeability of the blood-brain barrier to chemotherapy in metastatic brain tumors: establishing a treatment paradigm. J Clin Oncol 25(16):2306–2312

    Article  PubMed  Google Scholar 

  11. Hodi FS, Friedlander P et al (2008) Major response to imatinib mesylate in KIT-mutated melanoma. J Clin Oncol 26(12):2046–2051

    Article  PubMed  CAS  Google Scholar 

  12. Hodi FS, O’Day SJ et al (2010) Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 363(8):711–723

    Article  PubMed  CAS  Google Scholar 

  13. Kaehler KC, Piel S et al (2010) Update on immunologic therapy with anti-CTLA-4 antibodies in melanoma: identification of clinical and biological response patterns, immune-related adverse events, and their management. Semin Oncol 37(5):485–498

    Article  PubMed  CAS  Google Scholar 

  14. Keilholz U, Punt CJ et al (2005) Dacarbazine, cisplatin, and interferon-alfa-2b with or without interleukin-2 in metastatic melanoma: a randomized phase III trial (18951) of the European Organisation for Research and Treatment of Cancer Melanoma Group. J Clin Oncol 23(27):6747–6755

    Article  PubMed  CAS  Google Scholar 

  15. Ko JM, Fisher DE (2010) A new era: melanoma genetics and therapeutics. J Pathol 223(2):241–250

    PubMed  Google Scholar 

  16. Kortmann RD, Hoffmann W et al (1995) Radiotherapie bei Tumorschmerz. Onkologe 1:327–334

    Google Scholar 

  17. Poulikakos PI, Zhang C et al (2010) RAF inhibitors transactivate RAF dimers and ERK signalling in cells with wild-type BRAF. Nature 464(7287):427–430

    Article  PubMed  CAS  Google Scholar 

  18. Rades D, Freundt K et al (2010) Dose escalation for metastatic spinal cord compression in patients with relatively radioresistant tumors. Int J Radiat Oncol Biol Phys [Epub ahead of print]

  19. Schadendorf D, Ugurel S et al (2006) Dacarbazine (DTIC) versus vaccination with autologous peptide-pulsed dendritic cells (DC) in first-line treatment of patients with metastatic melanoma: a randomized phase III trial of the DC study group of the DeCOG. Ann Oncol 17(4):563–570

    Article  PubMed  CAS  Google Scholar 

  20. Schrama D, Reisfeld RA et al (2006) Antibody targeted drugs as cancer therapeutics. Nat Rev Drug Discov 5(2):147–159

    Article  PubMed  CAS  Google Scholar 

  21. Solit DB, Rosen N (2011) Resistance to BRAF inhibition in melanomas. N Engl J Med 364(8):772–774

    Article  PubMed  CAS  Google Scholar 

  22. Terheyden P, Houben R et al (2010) Response to imatinib mesylate depends on the presence of the V559A-mutated KIT oncogene. J Invest Dermatol 130(1):314–316

    Article  PubMed  CAS  Google Scholar 

  23. Testori A, Rutkowski P et al (2009) Surgery and radiotherapy in the treatment of cutaneous melanoma. Ann Oncol 20 Suppl 6(6):vi22–vi29

    Google Scholar 

  24. Ugurel S, Hildenbrand R et al (2005) Lack of clinical efficacy of imatinib in metastatic melanoma. Br J Cancer 92(8): 1398–1405

    Article  PubMed  CAS  Google Scholar 

  25. Ugurel S, Schadendorf D et al (2006) In vitro drug sensitivity predicts response and survival after individualized sensitivity-directed chemotherapy in metastatic melanoma: a multicenter phase II trial of the Dermatologic Cooperative Oncology Group. Clin Cancer Res 12(18):5454–5463

    Article  PubMed  CAS  Google Scholar 

  26. Ugurel S, Utikal J et al (2009) Tumor biomarkers in melanoma. Cancer Control 16(3):219–224

    PubMed  Google Scholar 

  27. Weide B, Eigentler TK et al (2010) Survival after intratumoral interleukin-2 treatment of 72 melanoma patients and response upon the first chemotherapy during follow-up. Cancer Immunol Immunother [Epub ahead of print]

  28. Wyman K, Atkins MB et al (2006) Multicenter Phase II trial of high-dose imatinib mesylate in metastatic melanoma: significant toxicity with no clinical efficacy. Cancer 106(9): 2005–2011

    Article  PubMed  CAS  Google Scholar 

  29. Yu AL, Gilman AL et al (1324) Anti-GD2 antibody with GM-CSF, interleukin-2, and isotretinoin for neuroblastoma. N Engl J Med 363(14):1324–1334

    Article  Google Scholar 

  30. Garbe C et al (2008) ADO Kurzleitlinie – malignes Melanom der Haut

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: BMS, Roche, Medac, Novartis, GSK.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J.C. Becker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ugurel, S., Becker, J. Therapie des inoperabel metastasierten Melanoms. Hautarzt 62, 423–429 (2011). https://doi.org/10.1007/s00105-010-2041-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-010-2041-5

Schlüsselwörter

Keywords

Navigation