Advances in Targeted and Immunotherapy for High-Risk Cutaneous Malignancies

Skin cancer remains the most commonly diagnosed malignancy worldwide, with basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma representing the most clinically significant types. While traditional treatments are effective for early-stage disease, advanced or metastatic cases often pose significant therapeutic challenges. Patients with high-risk or recurrent disease face limited options and poor prognoses. The emergence of immunotherapy has dramatically transformed the treatment landscape across multiple cancer types, including cutaneous malignancies. This review highlights recent advancements in immunotherapeutic strategies for BCC, cSCC, and melanoma, underscoring their growing importance in dermatologic oncology. We synthesize current evidence and ongoing clinical trials for immunotherapy across these three skin cancer types. We also explore the molecular mechanisms underpinning immune responsiveness and potential biomarkers of response. As immunotherapy continues to expand within dermatology, understanding its role, limitations, and future directions is essential for optimizing patient care. The integration of immunotherapy into dermatologic practice represents not only a therapeutic innovation but also a shift toward precision medicine in cutaneous oncology.