Immunotherapy for Skin Cancer

Introduction

Skin cancer is a life-threatening condition that has had a remarkable advancement in treatment options in recent years. Among all the advancements, immunotherapy stands out as a promising way that harnesses the body's immune system to kill cancer. This article elaborates on the principles behind immunotherapy and its transformative impact on the treatment of skin cancer.

What Is Skin Cancer?

Skin cancer is a type of cancer that originates from skin cells. Skin cancer occurs when the cells of the skin undergo mutation of their genetics; it may lead to uncontrolled, abnormal growth of the cells. This uncontrolled growth of abnormal cells leads to the growth of a mass or malignant tumor capable of invading surrounding structures. Most skin cancers are due to prolonged exposure to ultraviolet radiation from the sun or tanning beds. The other risk factors may happen in persons with fair skin, a history of sunburn, a family history, and a weakened immune system. The three main types of skin cancer are:

• Squamous cell carcinoma.

• Basal cell carcinoma.

• Melanoma.

What Is Immunotherapy?

Immunotherapy is a revolutionary form of treatment for cancer. It is also called biologic therapy. This immunotherapy treatment stimulates the immune system of the body to recognize and kill the cancer cells. When compared to other traditional methods of cancer treatment like radiation therapy or chemotherapy that involve a direct target on cancer cells, immunotherapy helps in enhancing the body's natural protective nature.

What Are the Types of Immunotherapy for Skin Cancer?

As immunotherapy has emerged as a powerful and effective treatment for skin cancer, especially melanoma, various types of immunotherapy are employed to stimulate the immune system in many different ways. Some of the key types include

• Checkpoint Inhibitors: Checkpoint inhibitors are the drugs that target particular proteins like CTLA-4 (cytotoxic T-lymphocyte associated protein 4) or PD-1(programmed cell death protein 1). These are the proteins that act as checkpoints to regulate the immune response to the body. Some of the checkpoint inhibitors are nivolumab, ipilimumab, and pembrolizumab.

• Interleukins: These are signaling proteins that stimulate immune responses. IL-2 (interleukin-2) is used in treating malignant melanoma or metastatic melanoma.

• CAR T-cell Therapy: This therapy genetically modifies the individual's T-cells. These T cells express the chimeric antigen receptors that target the cancer cells. This type of immunotherapy is mainly used in hematological cancers or blood cancers. However, this therapy is used to investigate solid tumors like melanoma.

• Interferons: These are the proteins that enhance the body's immune response to cancer cells. In some cases, melanoma is treated using interferon alfa-2b.

• Cytokine Therapy: This therapy involves small proteins called cytokines to modulate the immune system. One example is interleukin-2, but its use is less due to significant adverse effects.

• Talimogene Laherparepvec (T-VEC): It is an oncolytic viral therapy particularly used for treating advanced melanoma. It is a genetically modified herpes virus that directly attacks cancer cells and stimulates an immune response.

What Are the Benefits of Immunotherapy in Skin Cancer?

Immunotherapy has brought a massive benefit in the treatment of skin cancer, especially in the treatment of melanoma. Some of the benefits include

• Improvement in the Survival Rates: Immunotherapies, especially the use of checkpoint inhibitors, have given a noticeable increase in the survival rate in patients with skin cancers. Long-term survival outcomes have been observed in a substantial number of patients.

• Limited Recurrence: Immunotherapy is very effective in reducing the risk of cancer recurrence after the surgical removal of the tumor. It happens particularly in the most aggressive form of skin cancer, melanoma.

• Fewer Side Effects: Compared to traditional methods like chemotherapy or radiation therapy, immunotherapy causes fewer side effects. This translates to an improved quality of life for patients undergoing immunotherapy.

• Treatment for Metastatic Cancer: Immunotherapy has provided a viable treatment option for patients with advanced or metastatic melanoma, offering hope in situations where limited alternatives may exist.

• Personalization: Ongoing research aims to identify biomarkers that predict a patient's response to immunotherapy, allowing for more personalized treatment approaches. This could enhance treatment efficacy and minimize unnecessary exposure for non-responders.

What Are the Challenges and Considerations of Immunotherapy for Skin Cancer?

Though immunotherapy shows significant promise in the treatment of skin cancer, it also has certain challenges and considerations. Some of them include:

• Autoimmune Reactions: Immunotherapy may cause immune-related adverse events where the immune system attacks even the healthy cells, which leads to different side effects in different parts of the body. These immune-related adverse events can be managed by close monitoring or halting the treatment temporarily.

• Variability in the Immune Response: There will be no equal response from all the people from immunotherapy. Some may get a great response, but some patients may get very limited or no response to immunotherapy. Identifying predictive markers for the efficiency of the treatment is an active area of research to customize treatment approaches.

• Development of Resistance: In some cases, the persons may have a great response to immunotherapy, but later, as the disease progresses, they may develop resistance. Understanding the mechanism of resistance development may be a great challenge.

• Accessibility and Cost: This treatment for skin cancer is effective, so it may not be accessible for every patient. Efforts to address affordability and broaden access to immunotherapy are crucial to ensuring its benefits reach a broader population.

• Combination Therapy: Studies and researchers are exploring many combination approaches with different types of immunotherapies or their combination with other treatments like chemotherapy or targeted therapy. Finding the optimal combinations and understanding potential synergies and risks are ongoing areas of investigation.

• Limited Applications: Immunotherapy has shown remarkable outcomes in melanoma, but its effectiveness in basal and squamous cell carcinoma is limited. Research and studies are undergoing to make it a diverse applicant in all types of skin cancers.

Conclusion

Immunotherapy has gained a name for remarkable advancements in the treatment of skin cancers. Its success in improving patient outcomes and reducing side effects underscores its potential as a cornerstone in the fight against this prevalent and challenging disease. As research continues to evolve, immunotherapy offers hope for a brighter future in the battle against skin cancer.