Intralesional immunotherapy shows potential for treating various skin cancers

Key takeaways:

• Studies show that using intralesional therapy for nonmelanoma skin cancer results in cure rates between 91.7% and 100%.
• Intralesional immunotherapy could act as an alternative to intravenous therapy and surgery.

Intralesional immunotherapy shows potential as a treatment for cutaneous malignancies, including nonmelanoma skin cancer, according to a speaker at this year’s ODAC Dermatology, Aesthetic & Surgical Conference.

“Systemic melanoma therapy innovation helped usher in the world of immunotherapy,” Vishal A. Patel, MD, FAAD, director of dermatologic surgery, director of cutaneous oncology and associate professor of dermatology and of medicine/oncology at The George Washington University School of Medicine & Health Sciences, told Healio. “Shortly thereafter, immunotherapy was investigated and approved for use in [nonmelanoma skin cancer (NMSC)].”

According to Patel’s presentation, intralesional immunotherapy has been successful for quite some time in the treatment of both melanoma and NMSC as he referenced many studies that used intralesional therapy for a variety of NMSC types with reported cure rates between 91.7% and 100%.

Although intralesional immunotherapy has demonstrated efficacy in the treatment of NMSC, it has yet to be widely adopted. According to Patel, this treatment modality certainly has the potential to be accepted by the dermatological community as a valid option for NMSC.

In theory, intralesional immunotherapy could act as an alternative or neoadjuvant therapy to intravenous treatment for locally advanced cutaneous squamous cell carcinoma.

If used alternatively, it could maximize tissue concentration while minimizing risks for systemic exposure. If used as a neoadjuvant treatment, it could reduce potential disfigurement or dysfunction prior to surgery.

Intralesional immunotherapy may also be an alternative to surgery for patients that suffer from surgical fatigue, surgical aversion or basal cell nevus syndrome that is too numerous to count.

According to Patel, the key to intralesional adoption is making sure that doctors keep the injection frequency low and continue monitoring adverse events with the goal of completely avoiding any that are severe or life-threatening.

“Intralesional therapies have been around for centuries, and we are coming full circle to treatments of the past using technology of the future,” Patel said. “Clinicians should consider incorporating a variety of intralesional treatments in the variety of presentations skin cancer patients may have.”