Topical and Intralesional Immunotherapy for Skin Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Immunology and Immunotherapy".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 6246

Special Issue Editor


E-Mail Website1 Website2
Guest Editor
1. Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain
2. DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, Vigo, Spain
Interests: actinic damage; skin cancer; atopic dermatitis; photoprotection; health management

Special Issue Information

Dear Colleagues,

Skin cancer is the most common form of human cancer and has an increasing annual incidence. Currently, its management and follow-up represent a challenge for patients, physicians, and health systems due to its associated morbidity, impact on health-related quality of life, costs, and death.

Immunotherapy is revolutionizing cancer management, enabling much higher disease control rates. The immune system has been long recognized as a key element involved in the pathogenesis, progression, and persistence of skin cancer. From this scenario arises the clinical relevance of skin-directed immunotherapy, an expanding therapeutic pipeline that can be administered in different modalities and combinations without inducing systemic toxicity.

In this Special Issue of Cancers, experts in the field will update and critically analyse the available evidence on topical and intralesional immunotherapy for skin cancer, focusing on non-melanoma skin cancer, melanoma, and primary cutaneous lymphoma. New promising approaches will also be reviewed.

Dr. Ángeles Flórez
Guest Editor

Manuscript Submission Information

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Keywords

  • skin cancer
  • melanoma
  • squamous cell carcinoma
  • basal cell carcinoma
  • actinic damage
  • cutaneous lymphoma
  • extramammary Paget disease
  • imiquimod
  • topical immunotherapy
  • immune system

Published Papers (5 papers)

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Review

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19 pages, 1951 KiB  
Review
Topical Immunotherapy for Actinic Keratosis and Field Cancerization
by Laura Bernal Masferrer, Tamara Gracia Cazaña, Isabel Bernad Alonso, Marcial Álvarez-Salafranca, Manuel Almenara Blasco, María Gallego Rentero, Ángeles Juarranz de la Fuente and Yolanda Gilaberte
Cancers 2024, 16(6), 1133; https://doi.org/10.3390/cancers16061133 - 12 Mar 2024
Viewed by 1013
Abstract
This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from [...] Read more.
This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from their main effect on dysplastic cells, exert some immunological action, which in the end contributes to their efficacy. While treatments like 5-fluorouracil, imiquimod, photodynamic therapy, and nicotinamide are promising in the management of AKs, especially in immunocompetent individuals, their efficacy is somewhat reduced in solid organ transplant recipients due to immunosuppression. The analysis extends to optimal combination, focusing on cryoimmunotherapy as the most relevant. New immunotherapies include resimiquimod, ingenol disoxate, N-phosphonacetyl-L-aspartate (PALA), or anti-PD1 that have shown promising results, although more studies are needed in order to standardize their use. Full article
(This article belongs to the Special Issue Topical and Intralesional Immunotherapy for Skin Cancer)
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21 pages, 7330 KiB  
Review
Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma
by Gloria Baeza-Hernández and Javier Cañueto
Cancers 2024, 16(1), 158; https://doi.org/10.3390/cancers16010158 - 28 Dec 2023
Viewed by 1257
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most frequent cancer in humans and has the potential to progress locally, metastasize, and cause death in a subset of patients. cSCC is especially common in the elderly, and it will probably represent a major [...] Read more.
Cutaneous squamous cell carcinoma (cSCC) is the second most frequent cancer in humans and has the potential to progress locally, metastasize, and cause death in a subset of patients. cSCC is especially common in the elderly, and it will probably represent a major health concern in the near future. Surgery is the standard treatment for cSCC, but intralesional therapies can sometimes be considered for certain patients and under certain circumstances. The choice of intralesional treatment depends on the patient′s characteristics and the clinician′s previous experience and expertise. Here we are reviewing intralesional treatments for cSCC and keratoacanthoma (KA). We have started with some classic drugs, such as methotrexate and 5-fluorouracil, bleomycin, interferon, and cryosurgery, but also comment on electrochemotherapy. Finally, we have focused on novel therapies, some of which are under development, and future perspectives, including intralesional immunotherapy and oncolytic viruses. Full article
(This article belongs to the Special Issue Topical and Intralesional Immunotherapy for Skin Cancer)
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10 pages, 299 KiB  
Review
Topical and Intralesional Immunotherapy for the Management of Skin Cancer in Special Locations: Lips and Eyelids
by Cecilia Buján Bonino, Isabel Rodríguez-Blanco, Dolores Sánchez-Aguilar Rojas, Hugo A. Vázquez Veiga and Ángeles Flórez
Cancers 2023, 15(20), 5018; https://doi.org/10.3390/cancers15205018 - 17 Oct 2023
Viewed by 992
Abstract
The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may result in deformities in these areas, making alternative treatment options necessary. [...] Read more.
The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases. Full article
(This article belongs to the Special Issue Topical and Intralesional Immunotherapy for Skin Cancer)
21 pages, 385 KiB  
Review
Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review
by Sandra Martínez-Fernández, Beatriz González-Sixto, Martina Espasandín-Arias, Diego Soto-García and Ángeles Flórez
Cancers 2023, 15(18), 4468; https://doi.org/10.3390/cancers15184468 - 8 Sep 2023
Cited by 1 | Viewed by 1344
Abstract
The incidence of in situ melanoma (MIS) has increased over the last decades. The mainstay of treatment for MIS, including lentigo maligna (LM), is complete surgical excision with clear margins (0.5 to 1.0 cm). Nevertheless, MIS lesions often affect elderly patients with comorbidities [...] Read more.
The incidence of in situ melanoma (MIS) has increased over the last decades. The mainstay of treatment for MIS, including lentigo maligna (LM), is complete surgical excision with clear margins (0.5 to 1.0 cm). Nevertheless, MIS lesions often affect elderly patients with comorbidities and involve large lesions in cosmetically sensitive areas, which means surgery is not always appropriate. Non-surgical treatments have a role in these cases, and include radiotherapy, cryosurgery, immunotherapy, laser therapy, and other topical medications. This study aims to review the applications of immunotherapy in MIS, either in monotherapy or in combination with other therapeutic alternatives. The main forms of immunotherapy used are imiquimod and, to a lesser extent, intralesional interferon-α (IL-INF-α) and ingenol mebutate (IM). IL-INF-α and IM have not been studied as extensively as imiquimod, whose results in real-life practice are encouraging. The clearance and recurrence rates reported in MIS treated with imiquimod as monotherapy, or as an adjuvant after surgery with affected or narrow margins, make imiquimod a reliable therapeutic alternative in selected cases. Also, its use as a neoadjuvant therapy before surgery was shown to reduce the final surgical defect size required to confirm negative histologic margins. In conclusion, local immunotherapy is frequently used in clinical practice and experience confirms it to be an excellent option for certain patients. Full article
(This article belongs to the Special Issue Topical and Intralesional Immunotherapy for Skin Cancer)

Other

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16 pages, 1890 KiB  
Systematic Review
Topical Imiquimod in Primary Cutaneous Extramammary Paget’s Disease: A Systematic Review
by Fátima Mayo-Martínez, Ruggero Moro, David Millán-Esteban, Elisa Ríos-Viñuela, Iker Javier Bautista, Eduardo Nagore, Onofre Sanmartín and Beatriz Llombart
Cancers 2023, 15(23), 5665; https://doi.org/10.3390/cancers15235665 - 30 Nov 2023
Viewed by 1000
Abstract
Extramammary Paget’s disease (EMPD) is subclinical in extent and multifocal in nature. There is no global consensus for treatment, so its management represents a challenge in clinical practice. Therefore, we conducted a systematic review through the main electronic databases to assess the effectiveness [...] Read more.
Extramammary Paget’s disease (EMPD) is subclinical in extent and multifocal in nature. There is no global consensus for treatment, so its management represents a challenge in clinical practice. Therefore, we conducted a systematic review through the main electronic databases to assess the effectiveness of topical imiquimod in cutaneous EMPD and to discuss its management. Finally, 24 studies involving a total of 233 EMPD patients treated with topical imiquimod were selected. The topical imiquimod response rate was 67%, and the complete response (CR) rate was 48%. Patients were treated with a three–four times a week regimen in most cases, ranging between 2 to 52 weeks. In addition, imiquimod was applied as an adjunctive treatment in 21 patients, achieving a CR rate of 71%. Consequently, imiquimod therapy could achieve a good response ratio as a first-line treatment, as adjuvant and neo-adjuvant therapy, and as a treatment for recurrent disease. The heterogeneity between studies and the lack of a control arm made it impossible to conduct a meta-analysis. To improve the quality of evidence on EMPD, multicenter studies are essential to collect a larger number of patients and, consequently, obtain high-quality evidence to standardize treatment. The Prospero registration number is CRD42023447443. Full article
(This article belongs to the Special Issue Topical and Intralesional Immunotherapy for Skin Cancer)
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