Mortaja Mahsa, Demehri Shadmehr
Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
Cancer Lett. 2023 Oct 28;575:216406. doi: 10.1016/j.canlet.2023.216406. Epub 2023 Sep 19.
Cutaneous squamous cell carcinoma (cSCC) is the second most common malignancy in the world. Among many identified risk factors, immunosuppression is a major factor that contributes to cSCC development. Organ transplant recipients (OTRs) are at markedly increased risk of developing multiple cSCCs with a propensity for advanced metastatic disease, leading to significant morbidity and mortality. The severity of the cSCC phenotype in OTRs highlights the urgent need to identify effective preventive modalities in this population. Despite recent advances in skin cancer prevention (e.g., nicotinamide) and treatment (e.g., immune checkpoint blockade), these modalities have limited utility in OTRs due to the lack of efficacy or significant side effect. Topical treatments against precancerous skin lesions, actinic keratosis (AK), remain the primary strategy to prevent cSCC in OTRs, which also have significant deficiencies in this population. Herein, we review the epidemiology, risk factors, and current cSCC prevention strategies. We highlight the gaps and future clinical strategies to address cSCC risk in high-risk populations.
皮肤鳞状细胞癌（cSCC）是全球第二常见的恶性肿瘤。在众多已确定的风险因素中，免疫抑制是促成cSCC发生发展的主要因素。器官移植受者（OTR）患多发性cSCC的风险显著增加，且有发生晚期转移性疾病的倾向，会导致严重的发病率和死亡率。OTR中cSCC表型的严重性凸显了在这一人群中确定有效预防措施的迫切需求。尽管近期在皮肤癌预防（如烟酰胺）和治疗（如免疫检查点阻断）方面取得了进展，但由于缺乏疗效或存在显著副作用，这些方法在OTR中的应用有限。针对癌前皮肤病变光化性角化病（AK）的局部治疗仍然是预防OTR发生cSCC的主要策略，而这一策略在该人群中也存在显著不足。在此，我们综述了cSCC的流行病学、风险因素及当前的预防策略。我们强调了在高危人群中应对cSCC风险方面存在的差距及未来的临床策略。
