非黑色素瘤皮肤癌的治疗方法:护理标准和新兴方式。
Therapeutic Approaches for Non-Melanoma Skin Cancer: Standard of Care and Emerging Modalities.
发表日期:2024 Jun 27
作者:
Stefano Sol, Fabiana Boncimino, Kristina Todorova, Sarah Elizabeth Waszyn, Anna Mandinova
来源:
Stem Cell Research & Therapy
摘要:
皮肤癌包括一系列皮肤恶性肿瘤,其中非黑色素瘤皮肤癌(NMSC)是世界上最常见的肿瘤。皮肤暴露是引发 NMSC 的主要危险因素。紫外线 (UV) 光会诱导表皮细胞中促肿瘤和抑肿瘤基因的各种基因组畸变。与基质微环境改变和局部免疫抑制的相互作用相结合,这些畸变导致癌性病变的发生和扩展。手术切除仍然是这些病变最常见的治疗方法;然而,局部晚期或转移性疾病显着增加发病或死亡的机会。近年来,通过对 NMSC 致病机制的广泛研究,发现了许多药理学靶点,从而开发了新的治疗方法,包括治疗晚期和转移性基底细胞癌 (BCC) 的 Hedgehog 通路抑制剂和治疗晚期和转移性基底细胞癌 (BCC) 的 PD-1/PD-L1 抑制剂。局部晚期皮肤鳞状细胞癌(cSCC)和默克尔细胞癌(MCC)。尽管这些新药有效,但长期治疗经常会出现耐药性和耐受性问题。正在进行的研究旨在确定减少不良反应和提高耐受性的替代策略。本综述总结了当前和新兴的用于治疗 NMSC 的疗法。
Skin cancer encompasses a range of cutaneous malignancies, with non-melanoma skin cancers (NMSCs) being the most common neoplasm worldwide. Skin exposure is the leading risk factor for initiating NMSC. Ultraviolet (UV) light induces various genomic aberrations in both tumor-promoting and tumor-suppressing genes in epidermal cells. In conjunction with interactions with a changed stromal microenvironment and local immune suppression, these aberrations contribute to the occurrence and expansion of cancerous lesions. Surgical excision is still the most common treatment for these lesions; however, locally advanced or metastatic disease significantly increases the chances of morbidity or death. In recent years, numerous pharmacological targets were found through extensive research on the pathogenic mechanisms of NMSCs, leading to the development of novel treatments including Hedgehog pathway inhibitors for advanced and metastatic basal cell carcinoma (BCC) and PD-1/PD-L1 inhibitors for locally advanced cutaneous squamous cell carcinoma (cSCC) and Merkel cell carcinoma (MCC). Despite the efficacy of these new drugs, drug resistance and tolerability issues often arise with long-term treatment. Ongoing studies aim to identify alternative strategies with reduced adverse effects and increased tolerability. This review summarizes the current and emerging therapies used to treat NMSC.