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Immunomodulators for skin cancer.
Abstract
Therapeutic interventions to augment tumor antigenicity or increase the host's immune response against cancer cells include recombinant cytokines, immune modulators, vaccination with tumor antigens, T cell-based immunotherapy, and gene therapy. We describe the current role of the immunomodulators (up-regulators of the immune response) in the therapy of skin cancer (non melanoma skin cancer, melanoma, lymphoma, Kaposi sarcoma, and extramammary Paget's disease). ********** Basal Cell Carcinoma The treatment of choice for small basal cell carcinomas (BCCs) of the nodular and superficial types is surgical excision. Mohs micrographic surgery is indicated for head, neck, and other areas where tissue conservation in BCC treatment is critical but is also the treatment of choice in large, ill defined and morphea lesions (1). Immunomodulators in BCC Interferons: Based on their antiproliferative, antiviral and immunomodulatory properties Interferons (IFNs) have been studied as an alternative therapy in the treatment of cancer. Following intralesional interferon (IFN)-[alpha] treatment of BCC, BCC cells are induced to express FasR, while continuing to express FasL, making themselves susceptible to FasR/FasL-mediated apoptosis caused by BCC cell-BCC cell and/or T-lymphocyte-BCC cell interactions, as well to self-induced 'suicidal' apoptosis of individual BCC cells coexpressing FasR and FasL (2). Intralesional IFN-[alpha]2b, 1.5 million IU/used over a three to four-week period has an overall success rate in most clinical trials between 70 and 100% (3,4), which is lower than the cure rate of primary surgical excision (95%) or cryosurgery (94-99%) (5). When used for aggressive forms of BCC (recurrent or morpheaform) this protocol resul...See the full content of this document
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