The role of the immune system in
cancer growth is well recognized and the development of
immunotherapy represents a breakthrough in
cancer treatment. Recently, the use of systemic
immunotherapy was extended to keratinocyte
carcinoma (KC), specifically locally advanced and metastasizing basal and
squamous cell carcinoma. However, since most KC lesions are non-aggressive, systemic treatment with associated side effects is rarely justified. Conversely, topical
immunotherapy with
imiquimod remains restricted to premalignant and superficial lesions. Use of
laser in the treatment of KC has evolved from physical
tumor destruction and
laser-assisted drug delivery to
laser-mediated immune modulation. Evidence indicates that
laser monotherapy can lead to immune cell infiltration,
tumor reduction and resistance to
tumor re-inoculation. Combining
laser with immunotherapeutic agents, termed
laser immunotherapy (LIT), may further potentiate immune activation and
tumor response. Studies on LIT show not only direct anti-
tumor effects but systemic adaptive immunity, illustrated by the prevention of
tumor recurrence and regression in distant untreated
tumors. These findings imply a therapeutic potential for both local and metastatic disease. This work provides rationales for immune-based treatment of KC and presents the current status of KC
immunotherapy. Aiming to expand the field of KC
immunotherapy, the review discusses the literature on immune activation following
laser monotherapy and LIT.