Ciljana i imunoterapija metastatskog melanoma

master's thesis

• Title (english): Targeted and immunotherapy of metastatic melanoma
• Author: Kristina Horvat
• Mentor: Romana Čeović (mentor)
• Committee member: Zrinka Bukvić Mokos (predsjednik povjerenstva)
• Committee member: Branka Marinović (član povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Melanom je zloćudni tumor kože koji nastaje od pigmentiranih stanica melanocita. Njegov proširen i najagresivniji oblik je metastatski melanom. Melanom nastaje zbog različitih okolišnih i osobnih rizičnih čimbenika, od kojih je najbitnije spomenuti utjecaj UVB zraka odnosno izravno izlaganje Suncu. Upravo zbog tog razloga diljem svijeta kroz mnogobrojne javnozdravstvene akcije radi se na osvještavanju ljudi o štetnosti Sunca. Posebno osjetljiva populacija na izlaganje Sunčevoj emisiji su djeca jer time imaju veći rizik za kasnije razvijanje bolesti. Osim smanjenog izlaganja Suncu bitne su redovite samokontrole i što ranije javljanje liječniku ukoliko postoji sumnja na promijenjenu leziju. Prilikom dijagnostike prvi korak je detaljan fizikalni pregled i dermatoskopija, dok konačnu dijagnozu postavljamo nakon patohistološke analize. Melanom možemo podjeliti u četiri histološki različita oblika, a to su površinsko šireći, nodularni, lentigo maligni i akralni lentiginozni melanom. Nakon određivanja proširenosti bolesti i njezine histološke analize radi se staging po TNM-klasifikacija kako bi što bolje odredili primjerenu terapiju za svakog bolesnika. Terapija izbora kod lokalne bolesti i jedini konačni mogući oblik liječenja je kirurška ekscizija. Ukoliko je bolest proširena dodatan bitan korak je regionalna limfadenektomija. Kod prisutnosti udaljenih metastaza i neresektabilnih tumora terapija izbora su ciljana i imunoterapija. Njihovim otkrićem postignut je revolucionarni napredak u liječenju metastatskog melanoma i postignuti su rezultati kakvima se nitko prije nije niti nadao. Sveukupno preživljenje tih pacijenta povećano je na nekoliko godina, a daljnjim istraživanjima očekuje se još veći napredak.

Abstract (english)

Melanoma is a malignant tumor of the skin that arises from pigment cells called melanocytes. Its expanded and most aggressive form is metastatic melanoma. Melanoma develops due to different environmental and personal risk factors, the most important of which is the effect of UVB rays or direct exposure to sunlight. Precisely for this reason, all over the world through many public health actions awareness is being raised about the harmful effects of the sun. The children are particularly sensitive population to the sun exposure, because later in life they will have a greater risk for developing melanoma. In addition to reduced sun exposure, the most important prevention is regular self-control and seeking professional help if there is a suspicion of a changed lesion. The first step in diagnostics is a whole body check and dermatoscopy of suspicious lesions, while the final diagnosis is histopathological analysis. There are four different major histological subtypes of melanoma: superficial spreading melanoma, nodular melanoma, lentigo malignant melanoma, and acrylic lentiginous melanoma. After determining the extent of the disease and its histological analysis we should stage the tumor by the TNM classification in order to determine the appropriate treatment for each patient. The therapy of choice in locally spread disease is surgical excision. If the disease has spread to lymph nodes, an additional treatment solution is regional lymphadenectomy. In tumors with the presence of distant metastases and in unresectable tumors the therapy of choice is targeted and immunotherapy. Their discovery has been a revolutionary breakthrough in the treatment of metastatic melanoma and results that have been achieved were better than anyone had hoped for. Overall survival for these patients has increased by several years, and further research is expected to result in even greater progress.

• Keywords: melanom; imunoterapija; liječenje
• Keywords (english): melanoma; immunotherapy; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:303276
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta je unio ključne riječi.
• Created on: 2019-01-09 09:31:21