Cutaneous Oncology Department, Helen Diller Comprehensive Cancer Center, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA.
Head and Neck Oncology Department, Helen Diller Comprehensive Cancer Center, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA.
Am J Clin Dermatol. 2019 Dec;20(6):781-796. doi: 10.1007/s40257-019-00452-8.
Skin cancer, as the most physically accessible malignancy, allows for the greatest variety in treatment innovation. The last 2 decades have seen striking increases in the life expectancies of those diagnosed with malignant melanoma. However, many cases remain in which disease prevails against standard treatment, and those patients rely on continuing ingenuity. Drugs that can be injected directly into patients' tumors have become increasingly promising, not least for the reduction in side effects observed. Intratumoral therapy encompasses a wide array of agents, from chemotherapeutic drugs to cancer vaccines. While each show some efficacy, those agents which regulate the immune system likely have the greatest potential for preventing disease progression or recurrence. Recent research has highlighted the importance of the presence of cytotoxic T cells and of keeping regulatory T cells in check. Thus, manipulating the tumor microenvironment is a need in skin cancer therapy, which intratumoral delivery can potentially address. In order to find the best approach to each person's disease, more studies are needed to test intralesional agents in combination with currently approved therapies and with each other.
皮肤癌作为最易触及的恶性肿瘤，为治疗创新提供了最大的多样性。在过去的 20 年中，被诊断出患有恶性黑色素瘤的患者的预期寿命显著增加。然而，仍有许多病例中疾病对抗标准治疗，这些患者依赖于持续的创造力。可以直接注射到患者肿瘤内的药物越来越有前途，尤其是观察到副作用减少。肿瘤内治疗包括广泛的药物，从化疗药物到癌症疫苗。虽然每种药物都显示出一定的疗效，但那些调节免疫系统的药物可能具有最大的潜力来预防疾病的进展或复发。最近的研究强调了细胞毒性 T 细胞的存在以及保持调节性 T 细胞受到抑制的重要性。因此，操纵肿瘤微环境是皮肤癌治疗的需要，而肿瘤内递送可能会解决这一问题。为了找到针对每个人疾病的最佳方法，需要更多的研究来测试肿瘤内药物与目前批准的治疗方法以及彼此之间的联合应用。
