Recent Developments in Therapies and Diagnostic Tools for Melanoma and Non-melanoma Skin Cancer
This research comprises three sections: 1) recent therapeutic options for advanced melanoma and non-melanoma skin cancers; 2) investigation of biomarkers to predict the efficacy and adverse events (AEs) for melanoma and non-melanoma patients; and 3) novel diagnostic tools for skin cancers.
The last 5 years have seen a great paradigm shift in the treatment of skin cancers, particularly for advanced melanoma. Indeed, once immune checkpoint inhibitors and BRAF inhibitors became available, therapeutic strategies for the treatment of advanced melanoma have changed markedly, prolonging survival and even improving quality of life for patients. Subsequent to these successes in the treatment of advanced melanoma, dermato-oncologists have been trying to develop appropriate treatments for advanced non-melanoma skin cancers, such as cutaneous squamous cell carcinoma, extramammary Paget’s disease, Merkel cell carcinoma, and angiosarcoma. Such attempts have been made using data from pre-clinical investigations, such as of the cancer immunological microenvironment, signaling pathways for cell proliferation, and oncogenes. Based on the results from such pre-clinical investigations, several early clinical studies are now ongoing in the area of skin cancers.
Since therapeutic options for the treatment of advanced skin cancers are rapidly developing, optimization of novel therapies is needed. For example, the efficacy of nivolumab appears significantly increased when combined with ipilimumab, but the rate of severe treatment-related AEs (Grade 3 or 4) is unfortunately also significantly increased under this particular combination. To avoid severe AEs caused by ipilimumab, predictive biomarkers are needed to evaluate the efficacy of nivolumab monotherapy and allow preparation for planned switches from nivolumab to ipilimumab. For the reasons described above, dermato-oncologists have recently sought appropriate biomarkers to predict treatment efficacy and AEs.
In addition to the investigation of treatments for advanced-stage skin cancers, the development of diagnostic tools for skin cancer in the early stage is important for the treatment of skin cancers. Dermoscopy is a widely used, non-invasive technique that has greatly improved diagnostic accuracy for skin tumors, especially early-stage melanoma. However, dermoscopy is not useful for evaluating the vertical invasion of a tumor. Several recent studies have therefore reported on the development of novel diagnostic tools for skin cancers.
In this research topic, we highlight both novel and conventional diagnostic tools, as follows: dermoscopy; deep-learning based, computer-aided classifier tools; and diagnostic devices for skin cancer based on measurements of thermal conductivity.
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Journal of Clinical & Experimental Dermatology Research