A Review of Neoadjuvant PD-1 Inhibitors in the Setting of Cutaneous Malignancies

Considering the rapid pace of developments in the field of cancer immunotherapy, continuous updates on the topic are critical for the medical community. With incidences of cutaneous malignancies on the rise, it is more imperative than ever to utilize and understand current and future treatment modalities. Currently, the United States (US) Food and Drug Administration (FDA) approval for various immune checkpoint inhibitors (ICIs), particularly programmed cell death protein 1 (PD-1) inhibitors, in an adjuvant setting for various cutaneous malignancies is the mainstay in treatment of a number of cutaneous malignancies. Given the transformative potential of PD-1 inhibitors within the realm of immunotherapy, an understanding of the current state of research in this area is essential for dermatologists. This is important because in the cutaneous oncological world, neoadjuvant therapy is quickly demonstrating to show significant importance skin cancer treatment. Traditional neoadjuvant therapy involves a combination of chemotherapy, radiation, and/or targeted therapy, depending on the type and stage of malignancy. The main objective in these therapies has been to reduce tumor size for improved operability, manage systemic disease, and treat operable tumors prior to surgical intervention to obtain a more favorable long-term survivability. This review aims to provide a succinct analysis of both recent and current research of PD-1 inhibitors in the neoadjuvant setting of melanoma, squamous cell carcinoma, and merkel cell carcinoma.