Merkel Cell Carcinoma Center of Excellence, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Immunother Cancer. 2022 Jul;10(7). doi: 10.1136/jitc-2021-004434.
Nonmelanoma skin cancers (NMSCs) are some of the most commonly diagnosed malignancies. In general, early-stage NMSCs have favorable outcomes; however, a small subset of patients develop resistant, advanced, or metastatic disease, or aggressive subtypes that are more challenging to treat successfully. Recently, immune checkpoint inhibitors (ICIs) have been approved by the US Food and Drug Administration (FDA) for the treatment of Merkel cell carcinoma (MCC), cutaneous squamous cell carcinoma (CSCC), and basal cell carcinoma (BCC). Although ICIs have demonstrated activity against NMSCs, the routine clinical use of these agents may be more challenging due to a number of factors including the lack of predictive biomarkers, the need to consider special patient populations, the management of toxicity, and the assessment of atypical responses. With the goal of improving patient care by providing expert guidance to the oncology community, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew on the published literature as well as their own clinical experience to develop recommendations for healthcare professionals on important aspects of immunotherapeutic treatment for NMSCs, including staging, biomarker testing, patient selection, therapy selection, post-treatment response evaluation and surveillance, and patient quality of life (QOL) considerations, among others. The evidence- and consensus-based recommendations in this CPG are intended to provide guidance to cancer care professionals treating patients with NMSCs.
非黑色素瘤皮肤癌(NMSC)是最常见的诊断恶性肿瘤之一。一般来说,早期 NMSC 预后良好;然而,一小部分患者会发展为耐药、晚期或转移性疾病,或侵袭性亚型,这些疾病更难成功治疗。最近,美国食品和药物管理局(FDA)已批准免疫检查点抑制剂(ICI)用于治疗 Merkel 细胞癌(MCC)、皮肤鳞状细胞癌(CSCC)和基底细胞癌(BCC)。尽管 ICI 已被证明对 NMSC 有效,但由于缺乏预测生物标志物、需要考虑特殊患者群体、毒性管理以及评估非典型反应等诸多因素,这些药物的常规临床应用可能更具挑战性。为了通过为肿瘤学社区提供专家指导来改善患者护理,癌症免疫治疗学会(SITC)召集了一个多学科专家小组来制定临床实践指南(CPG)。专家组参考了已发表的文献和他们自己的临床经验,就免疫治疗 NMSC 的重要方面为医疗保健专业人员制定了建议,包括分期、生物标志物检测、患者选择、治疗选择、治疗后反应评估和监测以及患者生活质量(QOL)考虑等。本 CPG 中的基于证据和共识的建议旨在为治疗 NMSC 患者的癌症护理专业人员提供指导。