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Site-Specific Vesicular Drug Delivery System for Skin Cancer: A Novel Approach for Targeting. Gels 2021; 7:gels7040218. [PMID: 34842689 PMCID: PMC8628733 DOI: 10.3390/gels7040218] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 12/21/2022] Open
Abstract
Skin cancer, one of the most prevalent cancers worldwide, has demonstrated an alarming increase in prevalence and mortality. Hence, it is a public health issue and a high burden of disease, contributing to the economic burden in its treatment. There are multiple treatment options available for skin cancer, ranging from chemotherapy to surgery. However, these conventional treatment modalities possess several limitations, urging the need for the development of an effective and safe treatment for skin cancer that could provide targeted drug delivery and site-specific tumor penetration and minimize unwanted systemic toxicity. Therefore, it is vital to understand the critical biological barriers involved in skin cancer therapeutics for the optimal development of the formulations. Various nanocarriers for targeted delivery of chemotherapeutic drugs have been developed and extensively studied to overcome the limitations faced by topical conventional dosage forms. A site-specific vesicular drug delivery system appears to be an attractive strategy in topical drug delivery for the treatment of skin malignancies. In this review, vesicular drug delivery systems, including liposomes, niosomes, ethosomes, and transfersomes in developing novel drug delivery for skin cancer therapeutics, are discussed. Firstly, the prevalence statistics, current treatments, and limitations of convention dosage form for skin cancer treatment are discussed. Then, the common type of nanocarriers involved in the research for skin cancer treatment are summarized. Lastly, the utilization of vesicular drug delivery systems in delivering chemotherapeutics is reviewed and discussed, along with their beneficial aspects over other nanocarriers, safety concerns, and clinical aspects against skin cancer treatment.
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Najmi M, Sivesind TE, Thomson J, Hogan S, Dellavalle RP. From the Cochrane Library: Interventions for basal cell carcinoma of the skin. J Am Acad Dermatol 2021; 85:e417-e418. [PMID: 34499991 DOI: 10.1016/j.jaad.2021.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Maleka Najmi
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jason Thomson
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Sarah Hogan
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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53
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Fania L, Samela T, Moretta G, Ricci F, Dellambra E, Mancini M, Sampogna F, Panebianco A, Abeni D. Attitudes among dermatologists regarding non-melanoma skin cancer treatment options. Discov Oncol 2021; 12:31. [PMID: 35201447 PMCID: PMC8777506 DOI: 10.1007/s12672-021-00421-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/04/2021] [Indexed: 12/27/2022] Open
Abstract
Non-melanoma skin cancers include basal and squamous cell carcinoma. These tumors have become an important health issue for their high incidence and for the morbidity, especially if untreated for a long period. Over the last 20 years, therapeutic approaches for these tumours have been improved and tailored. In this survey we provided data from one hundred and ten Italian dermatologists regarding knowledge and attitude towards different therapeutic approaches on non-melanoma skin cancers. In our study, we observed that surgery and imiquimod 5% cream were the most used treatment by dermatologists for basal cell carcinoma, while, surgery was the most common treatment for cutaneous squamous cell carcinoma. Furthermore, we observed some differences regarding the prescribed therapies in the different Italian geographical areas (i.e., Mohs' surgery and electrochemotherapy were more frequently used in Northern compared to Central and Southern Italy whereas immunotherapy was more used in Southern compared to Northern and Central Italy) and even considering the year of specialization of the dermatologists (i.e., immunotherapy with cemiplimab was prescribed mainly by dermatologists with 10-19 years of specialization). However, for locally advanced and metastatic forms of basal and squamous cell carcinoma, Hedgehog Pathway Inhibitors and anti- Programmed cell death protein antibody treatment, respectively, were used in line with the newest evolution of therapies regarding this topic. Considering the importance of skin cancers and its progressive increase in incidence, it is crucial to improve the knowledge of different therapeutic approaches among dermatologists.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy.
| | - Tonia Samela
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Gaia Moretta
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Francesco Ricci
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Elena Dellambra
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Mara Mancini
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Francesca Sampogna
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Annarita Panebianco
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Damiano Abeni
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
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Membrive Jiménez C, Pérez Ramírez C, Sánchez Martín A, Vieira Maroun S, Arias Santiago S, Ramírez Tortosa MC, Jiménez Morales A. Clinical Application of Pharmacogenetic Markers in the Treatment of Dermatologic Pathologies. Pharmaceuticals (Basel) 2021; 14:ph14090905. [PMID: 34577605 PMCID: PMC8471650 DOI: 10.3390/ph14090905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 02/07/2023] Open
Abstract
Dermatologic pathologies are the fourth most common cause of non-fatal disease worldwide; however, they produce a psychosocial, economic, and occupational impact equal to or greater than other chronic conditions. The most prevalent are actinic keratosis, followed by basal-cell carcinoma, in a lesser proportion acne vulgaris, psoriasis, and hidradenitis suppurativa, among others, and more rarely dermatitis herpetiformis. To treat actinic keratosis and basal-cell carcinoma, 5-fluorouracil (5-FU) 0.5% is administered topically with good results, although in certain patients it produces severe toxicity. On the other hand, dapsone is a drug commonly used in inflammatory skin conditions such as dermatitis herpetiformis; however, it occasionally causes hemolytic anemia. Additionally, biologic drugs indicated for the treatment of moderate-to-severe psoriasis and hidradenitis suppurativa have proved to be effective and safe; nevertheless, a small percentage of patients do not respond to treatment with biologics in the long term or they are ineffective. This interindividual variability in response may be due to alterations in genes that encode proteins involved in the pathologic environment of the disease or the mechanism of action of the medication. Pharmacogenetics studies the relationship between genetic variations and drug response, which is useful for the early identification of non-responsive patients and those with a higher risk of developing toxicity upon treatment. This review describes the pharmacogenetic recommendations with the strongest evidence at present for the treatments used in dermatology, highlighting those included in clinical practice guides. Currently, we could only find pharmacogenetic clinical guidelines for 5-FU. However, the summary of product characteristics for dapsone contains a pharmacogenetic recommendation from the United States Food and Drug Administration. Finally, there is an enormous amount of information from pharmacogenetic studies in patients with dermatologic pathologies (mainly psoriasis) treated with biologic therapies, but they need to be validated in order to be included in clinical practice guides.
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Affiliation(s)
- Cristina Membrive Jiménez
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Cristina Pérez Ramírez
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
- Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n., Armilla, 18016 Granada, Spain;
- Correspondence:
| | - Almudena Sánchez Martín
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | - Sayleth Vieira Maroun
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
| | | | - María Carmen Ramírez Tortosa
- Center of Biomedical Research, Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, Avda. del Conocimiento s/n., Armilla, 18016 Granada, Spain;
| | - Alberto Jiménez Morales
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (C.M.J.); (A.S.M.); (S.V.M.); (A.J.M.)
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Pecora A, Laprise J, Dahmene M, Laurin M. Skin Cancers and the Contribution of Rho GTPase Signaling Networks to Their Progression. Cancers (Basel) 2021; 13:4362. [PMID: 34503171 PMCID: PMC8431333 DOI: 10.3390/cancers13174362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Skin cancers are the most common cancers worldwide. Among them, melanoma, basal cell carcinoma of the skin and cutaneous squamous cell carcinoma are the three major subtypes. These cancers are characterized by different genetic perturbations even though they are similarly caused by a lifelong exposure to the sun. The main oncogenic drivers of skin cancer initiation have been known for a while, yet it remains unclear what are the molecular events that mediate their oncogenic functions and that contribute to their progression. Moreover, patients with aggressive skin cancers have been known to develop resistance to currently available treatment, which is urging us to identify new therapeutic opportunities based on a better understanding of skin cancer biology. More recently, the contribution of cytoskeletal dynamics and Rho GTPase signaling networks to the progression of skin cancers has been highlighted by several studies. In this review, we underline the various perturbations in the activity and regulation of Rho GTPase network components that contribute to skin cancer development, and we explore the emerging therapeutic opportunities that are surfacing from these studies.
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Affiliation(s)
- Alessandra Pecora
- Oncology Division, CHU de Québec–Université Laval Research Center, Québec City, QC G1V 4G2, Canada; (A.P.); (J.L.); (M.D.)
| | - Justine Laprise
- Oncology Division, CHU de Québec–Université Laval Research Center, Québec City, QC G1V 4G2, Canada; (A.P.); (J.L.); (M.D.)
| | - Manel Dahmene
- Oncology Division, CHU de Québec–Université Laval Research Center, Québec City, QC G1V 4G2, Canada; (A.P.); (J.L.); (M.D.)
| | - Mélanie Laurin
- Oncology Division, CHU de Québec–Université Laval Research Center, Québec City, QC G1V 4G2, Canada; (A.P.); (J.L.); (M.D.)
- Université Laval Cancer Research Center, Université Laval, Québec City, QC G1R 3S3, Canada
- Molecular Biology, Medical Biochemistry and Pathology Department, Faculty of Medicine, Université Laval, Québec City, QC G1V OA6, Canada
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Fania L, Massone C, Cusano F, Fantini F, Dellambra E, Samela T, Passarelli F, Morese R, Tartaglione T, Maggiore M, Gentile P, Falchetto Osti M, Sampogna F, Pallotta S, Abeni D, Marchetti P, Naldi L. Integrated care pathways and the hub-and-spoke model for the management of non-melanoma skin cancer: A proposal of the Italian Association of Hospital Dermatologists (ADOI). Dermatol Reports 2021; 13:9278. [PMID: 34497705 PMCID: PMC8404423 DOI: 10.4081/dr.2021.9278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022] Open
Abstract
The term non-melanoma skin cancer (NMSC) refers to skin cancer different from melanoma, and it is usually restricted to basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and their pre-cancerous lesions, e.g., actinic keratosis. These conditions represent the most frequent tumors in Caucasians and are characterized by an increasing incidence worldwide and a high socio-economic impact. The term Integrated Care Pathway (ICP) refers to "a complex intervention for the mutual decision making and organization of care processes for a well-defined group of patients during a well-defined period". The purpose of this paper is to present a proposal from the Italian Association of Hospital Dermatologists (ADOI) for an ICP organization of care of NMSC, considering the hub-and-spoke model in the different geographical areas. This proposal is based on the most recent literature and on documents from the Italian Association of Medical Oncology (AIOM), the European consensus-based interdisciplinary guidelines from the European Association of Dermato- Oncology (EADO), and the National Comprehensive Cancer Network (NCCN). We initially discuss the NMSC outpatient clinic, the role of the multidisciplinary working groups, and the hub-and-spoke model regarding this topic. Then, we define the ICP processes specific for BCC and SCC. The ICP for NMSC is an innovative strategy to guarantee the highest possible quality of health care while the hub-andspoke model is crucial for the organization of different health care structures. Considering the importance on this topic, it is essential to create a valid ICP together with an efficient organization within the different geographical areas.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | - Tonia Samela
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | - Piercarlo Gentile
- University of Pittsburgh Medical Center, San Pietro Fatebenefratelli, Rome
| | | | | | | | | | | | - Luigi Naldi
- Centro Studi GISED, Bergamo and San Bortolo Hospital, Vicenza, Italy
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Yadav PR, Munni MN, Campbell L, Mostofa G, Dobson L, Shittu M, Pattanayek SK, Uddin MJ, Das DB. Translation of Polymeric Microneedles for Treatment of Human Diseases: Recent Trends, Progress, and Challenges. Pharmaceutics 2021; 13:1132. [PMID: 34452093 PMCID: PMC8401662 DOI: 10.3390/pharmaceutics13081132] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022] Open
Abstract
The ongoing search for biodegradable and biocompatible microneedles (MNs) that are strong enough to penetrate skin barriers, easy to prepare, and can be translated for clinical use continues. As such, this review paper is focused upon discussing the key points (e.g., choice polymeric MNs) for the translation of MNs from laboratory to clinical practice. The review reveals that polymers are most appropriately used for dissolvable and swellable MNs due to their wide range of tunable properties and that natural polymers are an ideal material choice as they structurally mimic native cellular environments. It has also been concluded that natural and synthetic polymer combinations are useful as polymers usually lack mechanical strength, stability, or other desired properties for the fabrication and insertion of MNs. This review evaluates fabrication methods and materials choice, disease and health conditions, clinical challenges, and the future of MNs in public healthcare services, focusing on literature from the last decade.
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Affiliation(s)
- Prateek Ranjan Yadav
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
- Chemical Engineering Department, Indian Institute of Technology, Delhi 110016, India;
| | | | - Lauryn Campbell
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | - Golam Mostofa
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (M.N.M.); (G.M.)
| | - Lewis Dobson
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | - Morayo Shittu
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | | | - Md. Jasim Uddin
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (M.N.M.); (G.M.)
- Department of Pharmacy, Brac University, 66 Mohakhali, Dhaka 1212, Bangladesh
| | - Diganta Bhusan Das
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
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58
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Farag AGA, El-Rebey HS, El-Moneim Shoeib MA, Ahmed El-Fiky SM, Elshaib ME, Mostafa AF. The Role of TROP2 in BCC and Cutaneous SCC: A Clinical and Immunohistochemical Study. Clin Cosmet Investig Dermatol 2021; 14:591-600. [PMID: 34103959 PMCID: PMC8179732 DOI: 10.2147/ccid.s299862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Nonmelanoma skin cancer (NMSC) mainly includes basal (BCC) and squamous (SCC) cell carcinoma. Trophoblast cell-surface antigen2 (TROP2), a cell-signal transduction, is one of the tumor-related calcium signal transducer gene family. TROP2 was highly expressed in many cancers, however, its role in BCC and SCC has not yet been studied. OBJECTIVE To investigate TROP2 immunohistochemical expression in BCC and SCC (lesional and peri-lesional) skin compared to controls and correlates its expression with the clinicopathologic parameters of the studied cases. METHODS This case-control study included 17 BCC and 15 SCC patients as well as 12 age and sex matched controls. History and clinical examination were completed. Histological examination of skin biopsies was done together with TROP2 immune-staining. RESULTS In the studied BCC and SCC cases, there was a significant stepwise up-regulation of TROP2 H score from control to peri-lesional, ended by lesional epidermis in one hand (p=0.003 for BCC and p<0.001 for SCC) and tumor island in another hand (p=0.001 for BCC and p=0.003 for SCC). TROP2 expression in both BCC and SCC tumor tissues was not affected by any of the studied clinicopathological parameters of the investigated cases. CONCLUSION TROP2 could have an important role in BCC and SCC pathogenesis. TROP2 targeting may have appraising effect in clinical application in BCC and SCC management.
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Affiliation(s)
- Azza Gaber Antar Farag
- Dermatology, Andrology and STDs Department, Faculty of Medicine, Menoufia University, Shebin ElKom, Egypt
| | - Hala Said El-Rebey
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin ElKom, Egypt
| | | | | | | | - Amal Farid Mostafa
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin ElKom, Egypt
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Mancini M, Cappello A, Pecorari R, Lena AM, Montanaro M, Fania L, Ricci F, Di Lella G, Piro MC, Abeni D, Dellambra E, Mauriello A, Melino G, Candi E. Involvement of transcribed lncRNA uc.291 and SWI/SNF complex in cutaneous squamous cell carcinoma. Discov Oncol 2021; 12:14. [PMID: 35201472 PMCID: PMC8777507 DOI: 10.1007/s12672-021-00409-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
While non-melanoma skin cancers (NMSCs) are the most common tumours in humans, only the sub-type cutaneous squamous cell carcinoma (cSCC), might become metastatic with high lethality. We have recently identified a regulatory pathway involving the lncRNA transcript uc.291 in controlling the expression of epidermal differentiation complex genes via the interaction with ACTL6A, a component of the chromatin remodelling complex SWI/SNF. Since transcribed ultra-conserved regions (T-UCRs) are expressed in normal tissues and are deregulated in tumorigenesis, here we hypothesize a potential role for dysregulation of this axis in cSCC, accounting for the de-differentiation process observed in aggressive poorly differentiated cutaneous carcinomas. We therefore analysed their expression patterns in human tumour biopsies at mRNA and protein levels. The results suggest that by altering chromatin accessibility of the epidermal differentiation complex genes, down-regulation of uc.291 and BRG1 expression contribute to the de-differentiation process seen in keratinocyte malignancy. This provides future direction for the identification of clinical biomarkers in cutaneous SCC. Analysis of publicly available data sets indicates that the above may also be a general feature for SCCs of different origins.
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Affiliation(s)
- M. Mancini
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - A. Cappello
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - R. Pecorari
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - A. M. Lena
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - M. Montanaro
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - L. Fania
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - F. Ricci
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - G. Di Lella
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - M. C. Piro
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - D. Abeni
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - E. Dellambra
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
| | - A. Mauriello
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - G. Melino
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
| | - E. Candi
- Istituto Dermopatico Dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy
- Department of Experimental Medicine, University of Rome “Tor Vergata”, via Montpellier 1, 00133 Rome, Italy
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60
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Fania L, Didona D, Di Pietro FR, Verkhovskaia S, Morese R, Paolino G, Donati M, Ricci F, Coco V, Ricci F, Candi E, Abeni D, Dellambra E. Cutaneous Squamous Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines 2021; 9:171. [PMID: 33572373 PMCID: PMC7916193 DOI: 10.3390/biomedicines9020171] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC), a non-melanoma skin cancer, is a keratinocyte carcinoma representing one of the most common cancers with an increasing incidence. cSCC could be in situ (e.g., Bowen's disease) or an invasive form. A significant cSCC risk factor is advanced age, together with cumulative sun exposure, fair skin, prolonged immunosuppression, and previous skin cancer diagnoses. Although most cSCCs can be treated by surgery, a fraction of them recur and metastasize, leading to death. cSCC could arise de novo or be the result of a progression of the actinic keratosis, an in situ carcinoma. The multistage process of cSCC development and progression is characterized by mutations in the genes involved in epidermal homeostasis and by several alterations, such as epigenetic modifications, viral infections, or microenvironmental changes. Thus, cSCC development is a gradual process with several histological- and pathological-defined stages. Dermoscopy and reflectance confocal microscopy enhanced the diagnostic accuracy of cSCC. Surgical excision is the first-line treatment for invasive cSCC. Moreover, radiotherapy may be considered as a primary treatment in patients not candidates for surgery. Extensive studies of cSCC pathogenic mechanisms identified several pharmaceutical targets and allowed the development of new systemic therapies, including immunotherapy with immune checkpoint inhibitors, such as Cemiplimab, and epidermal growth factor receptor inhibitors for metastatic and locally advanced cSCC. Furthermore, the implementation of prevention measures has been useful in patient management.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany;
| | - Francesca Romana Di Pietro
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Sofia Verkhovskaia
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Roberto Morese
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy;
| | - Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, 00128 Rome, Italy;
- Sikl’s Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, 30166 Pilsen, Czech Republic
| | - Francesca Ricci
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Valeria Coco
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, 00168 Rome, Italy;
| | - Francesco Ricci
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Eleonora Candi
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Damiano Abeni
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
| | - Elena Dellambra
- IDI-IRCCS, Dermatological Research Hospital, via di Monti di Creta 104, 00167 Rome, Italy; (F.R.D.P.); (S.V.); (R.M.); (F.R.); (F.R.); (E.C.); (D.A.); (E.D.)
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