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New Strategies for the Treatment of Melanoma and Non-Melanoma Skin Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 5420

Special Issue Editors


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Guest Editor
Department of Dermatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai 980-8574, Japan
Interests: systemic sclerosis; autoimmunity; angiogenesis; cancer-associated fibroblasts; irAE
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
Interests: skin cancer; immunotherapy; anti-PD-1 antibody; racial differences; prognosis

Special Issue Information

Dear Colleagues,

Current immunotherapy and targeted therapy for skin cancers: Perspectives on the Development of Novel Treatments

Since nivolumab became available in clinical practice in 2014, the treatment landscape for skin malignancies—including unresectable malignant melanoma—has undergone dramatic advancements. In fact, anti-PD-1 antibodies have significantly transformed the treatment of many cancers, including melanoma, lung cancer, and gastric cancer, serving as an anchor drug in various combination therapies, such as when combined with ipilimumab or relatlimab. Meanwhile, around the same time as the advent of immunotherapy in the field of skin cancer, the development of molecularly targeted drugs—for example, BRAF and MEK inhibitors for melanoma—was also underway. Based on various clinical trial results, Western countries recommend prioritizing immunotherapy as the first-line treatment for unresectable melanoma, with molecularly targeted therapy used sequentially. However, in East Asian melanoma patients, the efficacy of anti-PD-1 antibodies appears to differ from that observed in Western populations, with lower response rates observed. Furthermore, for BRAF wild-type melanoma that is resistant to anti-PD-1 antibodies, the combination therapy of nivolumab and ipilimumab remains the only treatment option available in Japan, although its safety and efficacy remain under debate. Due to these challenges, no established treatment exists for BRAF wild-type melanoma resistant to anti-PD-1 antibodies, particularly among Asian patients. Additionally, while clinical trials in Japan are evaluating the effects of anti-PD-1 antibodies on non-melanoma skin cancers, the therapeutic efficacy of immunotherapy for cutaneous squamous cell carcinoma has been found to be lower compared to reports from overseas. This Special Issue discusses the racial differences in the effectiveness of immunotherapy—centered on anti-PD-1 antibodies, an anchor drug in the treatment of skin cancer—from the perspectives of both basic research and clinical studies.

Prof. Dr. Yoshihide Asano
Dr. Taku Fujimura
Guest Editors

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Keywords

  • melanoma
  • non-melanoma skin cancer
  • immunotherapy
  • anti-PD-1 antibody
  • BRAF/MEK inhibitors
  • racial differences
  • prognosis

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Published Papers (4 papers)

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Research

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16 pages, 876 KB  
Article
The Real-World Efficacy and Side Effects of Different Nivolumab Regimens in Japanese Patients with Advanced Melanoma: A Single-Center Retrospective Study
by Ken Horisaki, Shusuke Yoshikawa, Wataru Omata, Arata Tsutsumida and Yoshio Kiyohara
Cancers 2025, 17(14), 2299; https://doi.org/10.3390/cancers17142299 - 10 Jul 2025
Viewed by 1804
Abstract
Background/Objectives: Nivolumab is a key therapy for advanced-stage melanoma; however, limited data are available from Asian populations comparing the efficacy and side effects of four dosing regimens: 3 mg/kg every 2 weeks (3mg/kgQ2W), 2 mg/kg every 3 weeks (2mg/kgQ3W), 240 mg every [...] Read more.
Background/Objectives: Nivolumab is a key therapy for advanced-stage melanoma; however, limited data are available from Asian populations comparing the efficacy and side effects of four dosing regimens: 3 mg/kg every 2 weeks (3mg/kgQ2W), 2 mg/kg every 3 weeks (2mg/kgQ3W), 240 mg every 2 weeks (240mgQ2W), and 480 mg every 4 weeks (480mgQ4W). This retrospective study evaluated Japanese patients with advanced melanoma treated with various nivolumab regimens to assess the impact of dosing interval and dosage on treatment efficacy and immune-related adverse events (irAEs). Methods: We reviewed the records of 153 participants with stage IV melanoma who received nivolumab monotherapy between February 2012 and December 2024 at Shizuoka Cancer Center. Patients were categorized by nivolumab regimen, dosing interval, and dose per body weight. We then compared treatment efficacy and incidence of irAEs across groups. Results: No significant differences were observed in objective response rate (ORR), progression-free survival (PFS), overall survival (OS), or irAE incidence between the 240mgQ2W and 480mgQ4W groups. Similar results were observed in the 3mg/kgQ2W and 2mg/kgQ3W groups. However, participants who received nivolumab within 3 weeks exhibited a significantly higher ORR than those who received nivolumab more than 3 weeks. No significant differences were found in PFS or OS. Conclusions: The administration of nivolumab at shorter intervals may provide short-term benefits in Japanese patients with advanced melanoma. However, long-term efficacy and side effects did not differ significantly across the studied nivolumab regimens. Full article
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Review

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18 pages, 495 KB  
Review
Immunotherapy for Cutaneous Squamous Cell Carcinoma in Aging Societies: Integrating Immunosenescence and Geriatric Oncology Perspectives
by Shigeto Matsushita, Kazuyasu Fujii and Megumi Aoki
Cancers 2026, 18(5), 749; https://doi.org/10.3390/cancers18050749 - 26 Feb 2026
Viewed by 400
Abstract
Background/Objectives: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide, with a steadily increasing incidence in aging populations, particularly among older and immunocompromised individuals. Early-stage cSCC disease is usually managed with surgery or radiotherapy; however, advanced or unresectable cases [...] Read more.
Background/Objectives: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide, with a steadily increasing incidence in aging populations, particularly among older and immunocompromised individuals. Early-stage cSCC disease is usually managed with surgery or radiotherapy; however, advanced or unresectable cases remain therapeutically challenging. The advent of immune checkpoint inhibitors (ICIs), especially programmed cell death protein 1 inhibitors, such as cemiplimab and pembrolizumab, has markedly improved outcomes in advanced cSCC. Nevertheless, resistance to immunotherapy, management of frail or super-aged patients, and optimal integration of systemic therapy with radiotherapy continue to pose important clinical questions. Methods: This review provides an updated overview of the current treatment strategies for cSCC, with particular attention to recent advances in systemic therapy and the application of geriatric oncology principles. We emphasize the considerations relevant to East Asian practices, especially in Japan, where the demographic shift toward a super-aged society magnifies the need for tailored approaches. Results: Although most pivotal clinical trials have been conducted in Western populations, emerging real-world data from East Asia have demonstrated comparable efficacy and safety of ICIs, underscoring the global relevance of immunotherapy in diverse patient groups. By incorporating a structured frailty assessment, individualized treatment goals, and proactive management of immune-related adverse events, this review highlights practical strategies for optimizing cSCC care in older patients. Conclusions: Future directions include predictive biomarker development; refinement of treatment sequencing; and multidisciplinary collaboration among oncology, dermatology, and geriatrics to adapt cSCC management to aging societies. Full article
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26 pages, 541 KB  
Review
Drug Therapy for Melanoma: Current Updates and Future Prospects
by Hiroshi Kato
Cancers 2026, 18(3), 382; https://doi.org/10.3390/cancers18030382 - 26 Jan 2026
Viewed by 1059
Abstract
Melanoma was once considered ‘incurable’; however, drug therapy for the condition has dramatically transformed with the advent of immune checkpoint inhibitors and molecular targeted therapies. In this review, we summarize the published literature on melanoma drug therapy, presenting the current landscape of melanoma [...] Read more.
Melanoma was once considered ‘incurable’; however, drug therapy for the condition has dramatically transformed with the advent of immune checkpoint inhibitors and molecular targeted therapies. In this review, we summarize the published literature on melanoma drug therapy, presenting the current landscape of melanoma treatments, and discuss potential future transformations in melanoma therapy. Although the prognosis of advanced-stage melanoma had been extremely poor in the past, new-age immunotherapy has made long-term survival possible. Several immunotherapies and their combinations, as well as personalized vaccines, cell therapies, and intratumoral agents, have been tested with success; however, adverse toxicities have also been detected. Therefore, patient selection and management are critical. Furthermore, new approaches to overcome the limitations of the current treatments are also being developed. To implement these therapies clinically, guideline-recommended treatment algorithms should be followed while optimizing the therapies by considering factors such as presence of BRAF mutations which may lead to treatment resistance, increased disease burden/progression rate, toxicity tolerance, and the presence of brain metastases. In practice, the choice of the initial therapy should depend on the patient, leading to personalized therapy and minimal adverse effects. Full article
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16 pages, 296 KB  
Review
Novel Therapeutic Approaches for Cutaneous Angiosarcoma, Particularly Focusing on Immune Checkpoint Inhibitors
by Yasuhiro Fujisawa
Cancers 2025, 17(19), 3163; https://doi.org/10.3390/cancers17193163 - 29 Sep 2025
Cited by 3 | Viewed by 1890
Abstract
Background/Objectives: Cutaneous angiosarcoma (CAS) is a rare and aggressive endothelial malignancy with a high rate of local recurrence and distant metastasis. In advanced cases, where surgical resection is not feasible, systemic therapy remains the cornerstone of treatment. This review aims to summarize [...] Read more.
Background/Objectives: Cutaneous angiosarcoma (CAS) is a rare and aggressive endothelial malignancy with a high rate of local recurrence and distant metastasis. In advanced cases, where surgical resection is not feasible, systemic therapy remains the cornerstone of treatment. This review aims to summarize the current landscape of systemic therapies for unresectable or metastatic CAS and discuss emerging strategies, particularly focusing on immune checkpoint inhibitors (ICIs). Methods: A comprehensive review of the literature was conducted, including clinical trials, retrospective studies, and case series focusing on systemic treatments for advanced CAS. Therapeutic approaches covered include cytotoxic chemotherapy, molecular targeted therapies, and ICIs, as well as combination strategies. Special attention was given to biomarker studies and ongoing clinical trials. Results: Taxane-based chemotherapy, particularly paclitaxel, has demonstrated clinical activity and remains a standard option. Molecular targeted agents such as pazopanib have yielded modest efficacy. Recent trials of ICIs, including the SWOG S1609 DART and AngioCheck studies, have shown encouraging results in select subgroups, especially tumors from sun-exposed regions associated with high tumor mutational burden (TMB). Although AngioCheck did not meet its predefined response criteria, a subset of patients achieved disease control. Biomarkers such as TMB, PD-L1 expression, and tumor-infiltrating lymphocytes are under investigation to guide patient selection. Combination therapies with ICIs and tyrosine kinase inhibitors (TKIs) are being actively explored. Conclusions: While systemic therapies for CAS remain limited in efficacy, ICIs—particularly in combination with TKIs—represent a promising avenue. Future trials should emphasize biomarker-driven, CAS-specific strategies to improve clinical outcomes in this challenging malignancy. Full article
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