ABSTRACT
@#[Abstract] In the past, surgery and chemotherapy were the main treatment strategies for malignant melanoma, but companied with poor prognosis. With the development of high-throughput gene sequencing technology and the deepening understanding of tumor molecular mechanisms, it has been found that tumor heterogeneity and the diversity of tumor microenvironment affect tumor formation, drug resistance and treatment selection, leading to different responses and benefits of melanoma patients to the same treatment. The emerge and progression of targeted therapy and immunotherapy have significantly increased the survival rates of patients with metastatic melanoma, promoting the individualization and precision of melanoma treatment and making precise treatment a research hotspot as well as a trend. This review mainly summarizes the research progress of systemic individualized treatment of advanced melanoma based on precise subtyping and molecular level, and to get a more comprehensive view of the survival status of melanoma patients in the era of precision medicine, as well as the prospect and necessity of developing various targeted therapy, immunotherapy or combination therapy.
ABSTRACT
@#[Abstract] Objective: To explore the expression patterns of melanoma lineage antigens and nuclear antigen Ki-67 and their correlations with survival in melanoma patients. Methods: A retrospective analysis was conducted to analyze the pathological data of melanoma patients treated at the Department of Melanoma, Peking University Cancer Hospital from February 2008 to August 2020, mainly including the expression patterns of melanoma lineage antigens (S-100, HMB-45, Melan-A) and Ki-67, demographics, clinical features and survival. The correlation between expression patterns of melanoma lineage antigens, Ki-67 and melanoma-specific survival (MSS) was analyzed. Results: In total, 603 patients were included in this study. The median follow-up time was 47.4 months. The positive rates of S-100, HMB, and Melan-A were 92.8%, 92.1% and 90.0%, respectively. The percentages of patients with melanoma lineage antigen scores (S-100, HMB-45 and Melan-A was scored each, as 1 when positive and 0 when negative) of 0, 1, 2, and 3 were 0.5%, 5.0%, 15.6%, and 78.8%, respectively. The percentages of patients with Ki-67 scores of 0, 1, 2, and 3 were 43.0%, 36.3%, 16.3%, and 4.5%, respectively. Ki-67 was highly expressed in mucosal and progressive melanomas. In a multivariate analysis, Ki-67 expression was an independent prognostic factor for poorer MSS (HR=1.506, 95%CI: 1.248-1.818, P<0.001) as the incidence of MSS event increased by 50% per 25% increase in Ki-67 expression, whereas there was no statistical correlation between melanoma lineage antigen expression and MSS (HR=0.991, 95%CI: 0.759-1.293, P=0.94). Conclusion: High expressions melanoma lineage antigens are ubiquitous in melanoma tissues, and Ki-67 is an independent prognostic factor for MSS.