尽管近几十年来黑色素瘤发病率不断上升，但总体死亡率呈下降趋势，反映出多种因素，包括转移性疾病治疗方案的改进。虽然局部治疗是早期黑色素瘤的主要治疗方法，但转移性疾病需要全身治疗，溶瘤病毒疗法成为一种有前途的选择。本次综述从 PubMed 检索 1964 年至 2024 年的文章。我们根据系统评价和荟萃分析指南的首选报告项目进行了标题、摘要和全文筛选，以识别描述柯萨奇病毒 A21 (V937) 使用的文章，作为恶性黑色素瘤的单一疗法或联合疗法的一部分。 15 篇文章符合纳入标准，提供了 V937 减轻肿瘤负荷功效的临床前和临床数据。除了报告可管理的安全性外，检验瘤内 V937 与 pembrolizumab 和 ipilimumab 联合疗法的临床试验数据也证实了与免疫检查点抑制剂单药疗法相比具有良好的客观缓解率（分别为 47% vs. 38% 和 21% vs. 10%）。相比之下，尽管在肿瘤组织中达到了可检测水平（1 × 109 TCID50），但静脉注射 V937 单一疗法未能在 IIIC/IV 期黑色素瘤患者队列（n = 3）中产生额外的益处。尽管一小部分患者经历了严重的不良反应，并且研究设计的限制对收集的数据造成了限制，但 V937 疗效的证据仍然令人鼓舞。由于很少有临床试验评估 V937 在黑色素瘤中的作用，因此在常规用于转移性病变的标准治疗之前需要额外的数据。© 2024 John Wiley

Despite rising melanoma incidence in recent decades, there is a trend towards overall decreased mortality, reflecting multiple factors including improved treatment options for metastatic disease. While local treatments are the mainstay for early-stage melanoma, metastatic disease necessitates systemic treatment, with oncolytic virotherapy emerging as a promising option. For this review, articles were retrieved from PubMed from 1964 through 2024. We conducted title, abstract and full-text screening in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify articles describing the use of coxsackievirus A21 (V937), either as monotherapy or as part of combination therapy for malignant melanoma. Fifteen articles met inclusion criteria, offering preclinical and clinical data on V937's efficacy in reducing tumour burden. In addition to reporting manageable safety profiles, clinical trial data examining intratumoral V937 combination therapy with pembrolizumab and ipilimumab also endorsed favourable objective response rates compared to immune checkpoint inhibitor monotherapy (47% vs. 38% and 21% vs. 10%, respectively). In contrast, intravenous V937 monotherapy failed to yield additional benefit in a cohort of patients with Stage IIIC/IV melanoma (n = 3) despite achieving detectable levels in tumour tissue (1 × 109 TCID50). Although small subsets of patients experienced severe adverse effects and study design limitations imposed constraints on collected data, evidence for the efficacy of V937 remains encouraging. With few clinical trials evaluating V937 in melanoma, additional data is required before routine usage in standard treatment for metastatic lesions.© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.