Zelin Enrico, Maronese Carlo Alberto, Dri Arianna, Toffoli Ludovica, Di Meo Nicola, Nazzaro Gianluca, Zalaudek Iris
Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy.
Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2022 Jun 11;11(12):3364. doi: 10.3390/jcm11123364.
Non-melanoma skin cancer (NMSC) stands as an umbrella term for common cutaneous malignancies, including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), together with rarer cutaneous cancers, such as Merkel cell carcinoma (MCC) and other forms of adnexal cancers. The majority of NMSCs can be successfully treated with surgery or radiotherapy, but advanced and metastatic stages may require systemic approaches such as immunotherapy with immune checkpoint inhibitors (ICIs).
Since immunotherapy is not effective in all patients and can potentially lead to severe adverse effects, an important clinical question is how to properly identify those who could be suitable candidates for this therapeutic choice. In this paper, we review the potential features and biomarkers used to predict the outcome of ICIs therapy for NMSCs. Moreover, we analyze the role of immunotherapy in special populations, such as the elderly, immunocompromised patients, organ transplant recipients, and subjects suffering from autoimmune conditions.
Many clinical, serum, histopathological, and genetic features have been investigated as potential predictors of response in NMSCs treated with ICIs. Although this field of research is very promising, definitive, cost-effective, and reproducible biomarkers are still lacking and further efforts are needed to validate the suggested predictors in larger cohorts.
非黑色素瘤皮肤癌（NMSC）是常见皮肤恶性肿瘤的统称，包括基底细胞癌（BCC）和皮肤鳞状细胞癌（cSCC），以及罕见的皮肤癌，如默克尔细胞癌（MCC）和其他形式的附属器癌。大多数NMSC可通过手术或放疗成功治疗，但晚期和转移阶段可能需要全身治疗方法，如使用免疫检查点抑制剂（ICI）进行免疫治疗。
由于免疫治疗并非对所有患者都有效，且可能导致严重不良反应，一个重要的临床问题是如何正确识别那些可能适合这种治疗选择的患者。在本文中，我们回顾了用于预测NMSC的ICI治疗结果的潜在特征和生物标志物。此外，我们分析了免疫治疗在特殊人群中的作用，如老年人、免疫功能低下患者、器官移植受者以及患有自身免疫性疾病的患者。
许多临床、血清、组织病理学和基因特征已被研究作为接受ICI治疗的NMSC反应的潜在预测指标。尽管该研究领域很有前景，但仍缺乏明确、具有成本效益且可重复的生物标志物，需要进一步努力在更大的队列中验证所建议的预测指标。
