Actualización del tratamiento sistémico del melanoma metastásico, terapias dirigidas e inmunoterapia
El melanoma constituye el tipo de cáncer dermatológico más letal, tras el carcinoma de células de Merkel, suponiendo en torno a un 2,3% del total de los diagnósticos de cáncer en España, con 5000 nuevos casos al año (1). La tasa de incidencia ajustada por 100.000 habitantes se sitúa entre 5.2-8.6 nuevos casos/año para el total de población, mostrando una incidencia creciente. Por otra parte, la mortalidad por melanoma estimada en nuestro país para el año 2012 fue de 967 casos (1). Aunque la mayor parte de los melanomas se diagnostican en fases tempranas, un porcentaje nada desdeñable de los mismos (19-25%) recidivan y/o debutan en situación avanzada locorregional y/o a distancia.
Hasta el año 2010, el tratamiento sistémico del melanoma metastásico se basaba fundamentalmente en quimioterapia, si bien los resultados se consideraban globalmente decepcionantes, con medianas de supervivencia de 6-9 meses (2). Sin embargo, en los últimos años hemos asistido a una revolución en la terapia sistémica del melanoma, de la mano de terapias dirigidas y de la moderna inmunoterapia.
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