The management of advanced cutaneous squamous cell carcinoma (CSCC) has been revolutionized by the introduction of immunotherapy. Yet, successful treatment with immunotherapy relies on an adequate antitumor immune response. Patients who are solid-organ transplant recipients (SOTRs) have a higher incidence of CSCC compared to the general population. This review discusses the current knowledge of epidemiology, pathophysiology, and management of patients with CSCC who are immunocompromised because of their chronic exposure to immunosuppressive medications to prevent allograft rejection. First, we discuss the prognostic impact of immunosuppression in patients with CSCC. Next, we review the risk of CSCC development in immunosuppressed patients due to SOT. In addition, we provide an overview of the biological immune disruption present in transplanted immunosuppressed CSCC patients. We discuss the available evidence on the use of immunotherapy and provide a framework for the management approach with SOTRs with CSCC. Finally, we discuss potential novel approaches that are being investigated for the management of immunosuppressed patients with CSCC.
免疫疗法的引入彻底改变了晚期皮肤鳞状细胞癌的治疗格局。然而，免疫疗法的成功应用依赖于机体产生足够的抗肿瘤免疫应答。相较于普通人群，实体器官移植受者群体中皮肤鳞状细胞癌的发病率显著升高。本综述系统阐述了因长期使用免疫抑制药物预防移植物排斥而导致免疫功能受损的皮肤鳞状细胞癌患者，在流行病学特征、病理生理机制及临床管理策略方面的研究进展。首先，我们探讨免疫抑制状态对皮肤鳞状细胞癌患者预后的影响；其次，分析实体器官移植所致免疫抑制患者发生皮肤鳞状细胞癌的风险特征；进而，系统概述移植后免疫抑制状态下皮肤鳞状细胞癌患者的生物学免疫紊乱机制。在临床实践方面，我们梳理了免疫疗法在该群体中应用的最新证据，并构建了实体器官移植受者合并皮肤鳞状细胞癌的诊疗框架。最后，针对免疫抑制状态下的皮肤鳞状细胞癌患者，我们探讨了当前正在研究中的创新治疗策略。
肿瘤(癌症)患者之家