Emerging Indications for Neoadjuvant Systemic Therapies in Cutaneous Malignancies

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• High-risk cutaneous malignancies with locoregional involvement often recur despite optimal surgery and adjuvant therapy.
• Existing treatments may not fully address the complex immune interactions in advanced skin cancers.

Purpose of the Study:

• To explore the potential advantages of neoadjuvant therapy over adjuvant treatment for skin cancers.
• To evaluate neoadjuvant immunotherapy's role in enhancing anti-tumor immune responses prior to surgical resection.

Main Methods:

• Review of preclinical studies and in vivo trials investigating neoadjuvant immunotherapy.
• Analysis of potential benefits including immune response modulation, antigen presentation, and immune cell targeting.

Main Results:

• Pre-surgical immunotherapy exposure can stimulate a broader, more robust immune response.
• Increased tumor cell antigen presentation and improved immune cell targeting are observed.
• Neoadjuvant therapy may allow for pathological response evaluation for personalized treatment.

Conclusions:

• Neoadjuvant therapy offers potential advantages for improving outcomes in melanoma, Merkel cell carcinoma, and cutaneous squamous-cell carcinoma.
• While further data on patient selection and biomarkers are needed, neoadjuvant therapy represents a potential paradigm shift for high-risk skin tumors.