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Emerging therapies for rare cutaneous cancers: A systematic review
Andrew Garcia1, Kamaria Nelson2, Vishal Patel2
1The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Background:
Rare cutaneous cancers require early management given their aggressive nature; however, few therapeutic options exist for managing these rare cancers.
Objective:
To identify emerging therapies for extramammary Paget's disease, Merkel cell carcinoma, sebaceous gland carcinoma, microcystic adnexal carcinoma, Kaposi sarcoma and cutaneous angiosarcoma.
Methods:
A systematic review was conducted using PubMed database from October 2010 to October 2020. Published clinical trials and case reports/series were included if they involved primarily a targeted agent rather than classic cytotoxic chemotherapy or photosensitizing medication. Active clinical trials were evaluated using ClinicalTrials.gov, the Japanese University Hospitals Clinical Information Network, and the ISRCTN registry. Quality of evidence for each study was rated using the Oxford Centre for Evidence-Based Medicine Level of Evidence Rating Scale.
Results:
There are several emerging therapies for rare cutaneous cancers with many clinical trials actively recruiting. PD-1 receptor inhibitors were the most investigated treatment, targeting several cancers. Merkel cell carcinoma and Kaposi sarcoma had the most clinical trials while microcystic adnexal carcinoma and sebaceous gland carcinoma had the least. The main limitation was a lack of key findings from clinical trials still in progress.
Conclusions:
Emerging therapies exist for rare cutaneous cancers; results of ongoing studies will provide more robust evidence in the future.
Insights
Emerging targeted therapies show promise for rare skin cancers like Merkel cell carcinoma. Ongoing clinical trials are evaluating treatments such as PD-1 receptor inhibitors, with results expected to offer more evidence.
Area of Science:
- Oncology
- Dermatology
- Cancer Research
Background:
- Rare cutaneous cancers are aggressive and have limited treatment options.
- Early management is crucial for these challenging malignancies.
Purpose of the Study:
- To identify emerging therapies for rare skin cancers including extramammary Paget's disease, Merkel cell carcinoma, sebaceous gland carcinoma, microcystic adnexal carcinoma, Kaposi sarcoma, and cutaneous angiosarcoma.
- To review current clinical trials and evidence quality for these novel treatments.
Main Methods:
- Systematic review of PubMed (2010-2020) for targeted agents in rare cutaneous cancers.
- Inclusion of published clinical trials and case reports, excluding cytotoxic chemotherapy.
- Evaluation of active clinical trials via ClinicalTrials.gov, JUH-CIN, and ISRCTN, with evidence rating using Oxford Centre for Evidence-Based Medicine criteria.
Main Results:
- Several emerging therapies are under investigation for rare cutaneous cancers, with numerous trials recruiting.
- PD-1 receptor inhibitors are the most studied targeted agents across multiple rare skin cancers.
- Merkel cell carcinoma and Kaposi sarcoma have the highest number of associated clinical trials.
Conclusions:
- Emerging targeted therapies offer new hope for patients with rare cutaneous cancers.
- Ongoing clinical trials are essential for generating robust evidence on treatment efficacy and safety.
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