81.3 🩺 內科專科考前版

81.3.0.1 📌 䞀頁重點

  • 22E: relatlimab (anti-LAG-3) + nivolumab approved melanoma; tebentafusp uveal; T-VEC
  • Taiwan: acral lentiginous melanoma 圚亞掲人占倚敞與西方流行病孞䞍同

81.3.0.2 🌟 Pearls (10)

  1. Relatlimab + nivolumab (Opdualag) — anti-LAG-3 + PD-1 melanoma
  2. Tebentafusp for uveal melanoma (HLA-A*0201)
  3. T-VEC intralesional oncolytic HSV
  4. TIL therapy (lifileucel) approved for advanced melanoma
  5. Acral lentiginous melanoma 亞掲族矀占倧宗 (~50%)
  6. CKIT mutation in acral / mucosal melanoma → imatinib
  7. Sentinel LN positive 䞍䞀定 require completion LND (DeCOG-SLT, MSLT-II)
  8. Mohs for cosmetic / recurrent / aggressive
  9. Cemiplimab for advanced BCC (post-Hedgehog failure)
  10. Pembrolizumab adjuvant Stage IIB/IIC + III

81.3.0.3 📍 Taiwan

  • 健保 BRAF/MEK for V600E melanoma
  • 健保 PD-1 (pembro/nivo) for advanced melanoma
  • 健保 ipilimumab + nivolumab 限制
  • 健保 vismodegib advanced BCC
  • 亞掲皮膚癌型態acral lentiginous > superficial spreading
  • Mohs micrographic surgery 圚台灣 expanding

81.3.0.4 🎓 內專重點

  1. 3 倧皮膚癌差異
  2. Melanoma ABCDE + Breslow
  3. Acral lentiginous (Taiwan)
  4. Adjuvant + advanced drugs
  5. BRAF/MEK + PD-1 + LAG-3 (22E)
  6. Mohs + sentinel LN

⚠ AI 草皿。