Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer

Non-melanoma skin cancers (NMSCs), which represent a diverse group of cutaneous malignancies, are the most common forms of human neoplasia. The incidence of these diseases is increasing due to a number of factors, including that of increasing human lifespans. The majority of NMSCs are basal cell car...

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Main Authors: Keiji Tanese, Yoshio Nakamura, Ikuko Hirai, Takeru Funakoshi
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-07-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fmed.2019.00160/full
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author Keiji Tanese
Yoshio Nakamura
Ikuko Hirai
Takeru Funakoshi
author_facet Keiji Tanese
Yoshio Nakamura
Ikuko Hirai
Takeru Funakoshi
author_sort Keiji Tanese
collection DOAJ
description Non-melanoma skin cancers (NMSCs), which represent a diverse group of cutaneous malignancies, are the most common forms of human neoplasia. The incidence of these diseases is increasing due to a number of factors, including that of increasing human lifespans. The majority of NMSCs are basal cell carcinomas (BCC) and cutaneous squamous cell carcinomas (cSCC), with the remainder being various rare skin cancers, including extramammary Paget's disease (EMPD), Merkel cell carcinoma (MCC), and several skin adnexal carcinomas. Of these, MCC usually shows aggressive behavior with a high mortality rate. On the other hand, BCC, cSCC, EMPD, and skin adnexal tumors usually show an indolent clinical course and metastasize only rarely. Nevertheless, the metastatic forms of these tumors commonly lead to poor patient outcome. A definitive management strategy for the treatment of advanced NMSC has not been established, mainly due to their rarity and lack of reliable information based on well-controlled randomized trials. Chemotherapeutic regimens for treatment of these diseases have been mainly based on the observations of isolated, small case series or clinical trials with a limited numbers of patients. However, accumulating evidence regarding their pathobiological backgrounds as well as recent advances in molecular biotechnology have facilitated the development of novel drugs for treatment of these diseases. Over the past decade, the U.S. Food and Drug Administration has approved several molecular targeting therapies, including Hedgehog inhibitors for BCC, monoclonal antibodies targeting anti-programmed death ligand-1 and anti- programmed cell death 1 (PD-1) for MCC, and anti-PD-1 for cSCC. Here, we review their clinical utility and discuss updated systemic treatment strategies for advanced NMSC.
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spelling doaj.art-dde9a581f8414f4e80030d7643683fb12022-12-21T18:45:09ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2019-07-01610.3389/fmed.2019.00160477532Updates on the Systemic Treatment of Advanced Non-melanoma Skin CancerKeiji TaneseYoshio NakamuraIkuko HiraiTakeru FunakoshiNon-melanoma skin cancers (NMSCs), which represent a diverse group of cutaneous malignancies, are the most common forms of human neoplasia. The incidence of these diseases is increasing due to a number of factors, including that of increasing human lifespans. The majority of NMSCs are basal cell carcinomas (BCC) and cutaneous squamous cell carcinomas (cSCC), with the remainder being various rare skin cancers, including extramammary Paget's disease (EMPD), Merkel cell carcinoma (MCC), and several skin adnexal carcinomas. Of these, MCC usually shows aggressive behavior with a high mortality rate. On the other hand, BCC, cSCC, EMPD, and skin adnexal tumors usually show an indolent clinical course and metastasize only rarely. Nevertheless, the metastatic forms of these tumors commonly lead to poor patient outcome. A definitive management strategy for the treatment of advanced NMSC has not been established, mainly due to their rarity and lack of reliable information based on well-controlled randomized trials. Chemotherapeutic regimens for treatment of these diseases have been mainly based on the observations of isolated, small case series or clinical trials with a limited numbers of patients. However, accumulating evidence regarding their pathobiological backgrounds as well as recent advances in molecular biotechnology have facilitated the development of novel drugs for treatment of these diseases. Over the past decade, the U.S. Food and Drug Administration has approved several molecular targeting therapies, including Hedgehog inhibitors for BCC, monoclonal antibodies targeting anti-programmed death ligand-1 and anti- programmed cell death 1 (PD-1) for MCC, and anti-PD-1 for cSCC. Here, we review their clinical utility and discuss updated systemic treatment strategies for advanced NMSC.https://www.frontiersin.org/article/10.3389/fmed.2019.00160/fullsquamous cell carcinomabasal cell carcinomaextramammary Paget's diseasemerkel cell carcinomaadnexal carcinoma
spellingShingle Keiji Tanese
Yoshio Nakamura
Ikuko Hirai
Takeru Funakoshi
Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
Frontiers in Medicine
squamous cell carcinoma
basal cell carcinoma
extramammary Paget's disease
merkel cell carcinoma
adnexal carcinoma
title Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
title_full Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
title_fullStr Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
title_full_unstemmed Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
title_short Updates on the Systemic Treatment of Advanced Non-melanoma Skin Cancer
title_sort updates on the systemic treatment of advanced non melanoma skin cancer
topic squamous cell carcinoma
basal cell carcinoma
extramammary Paget's disease
merkel cell carcinoma
adnexal carcinoma
url https://www.frontiersin.org/article/10.3389/fmed.2019.00160/full
work_keys_str_mv AT keijitanese updatesonthesystemictreatmentofadvancednonmelanomaskincancer
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AT ikukohirai updatesonthesystemictreatmentofadvancednonmelanomaskincancer
AT takerufunakoshi updatesonthesystemictreatmentofadvancednonmelanomaskincancer