Immunotherapy for nonmelanoma skin cancer - Does it have a future?

BACKGROUND. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin are the most common malignancies in the white human population, accounting for greater than 95% of nonmelanoma skin cancers (NMSCs). Current data show an increasing incidence of NMSC in recent decades. Although the mortality is low, this cancer group is associated with substantial morbidity. Multiple treatment modalities are available for NMSC, with surgery being a "cornerstone" of current therapy approaches. However, in patients with multiple lesions or in cases of tumors on critical locations, disfigurement and the disease recurrence may represent a serious problem associated with the surgical treatment. The purpose of this study was to review and analyze whether NMSC could represent a target for immune therapy, evaluating the aspects of the availability of tumor antigens and the existence of tumor specific immune response, including a summary of the major clinical studies dealing with immunotherapy for NMSC. METHODS. The authors have reviewed the available medical literature on NMSC, with a focus on tumor immunology and associated abnormalities, as well as immunotherapy-based treatment trials. RESULTS. The major advantage of NMSCs is that they arise from the skin, which makes them easily detectable and treatable. Furthermore, these tumors posses an the prerequisites, i.e., the presence of tumor-associated antigens as well as the tumor specific immune response, needed for immune intervention. This also was confirmed in various studies demonstrating clinical efficacy of cytokines and other immune response modifiers. CONCLUSIONS. In addition to clinical cure, by activating and stimulating patient's immune resources this therapeutic option may be a "silver bullet," providing a long-term protective immunity against initial tumor. (C) 2002 American Cancer Society.