Cytokines have been tested in the treatment of different
skin cancers during the last decade, and treatment schedules have been established or proposed for several malignant skin
tumors. Preferentially, the
interferons and
interleukin-2 were found to be effective in treating
skin cancers.
Interferons alpha and beta have been approved for the treatment of human immunodeficiency virus (HIV)-associated
Kaposi's sarcoma,
cutaneous T cell lymphoma, and
malignant melanoma in several countries.
Interferon alpha was found to be most effective in
cutaneous T cell lymphoma with 40%-60% overall responses. When combining
interferon alpha with
psoralens and ultraviolet A (PUVA) or with
retinoids, even higher response rates up to 60%-90% were reported, and long-term remissions have been described. A considerable activity of
interferon alpha was found in HIV-associated
Kaposi's sarcoma with response rates of 30%-50%. The effectiveness of
Kaposi's sarcoma's treatment was further improved by combining
interferon alpha and
zidovudine. Responses to
interferon alpha in metastatic
malignant melanoma are rather seldom (10%-15%), but a stabilization of the disease with prolonged survival was reported after
interferon alpha treatment. Additionally,
interleukin-2 was found to be active in metastatic
melanoma, with overall response rates of about 20%, and both
biological agents were found to have an additive efficacy in combination. Several combined regimens of
interferon alpha,
interleukin-2, and
polychemotherapy have been described in metastatic
melanoma, and overall response rates higher than 50% were found with these combined treatment modalities.
Interferon alpha and beta were also intralesionally injected into
basal cell carcinomas and other epithelial
skin cancers, and complete responses were found in more than 80% of
tumors treated. Local applications of
interferons and
interleukin-2 were likewise found to be effective in the treatment of cutaneous
melanoma metastases and cutaneous manifestations of
Kaposi's sarcoma.
Cytokines and their combination with other treatment modalities has greatly enriched the treatment facilities in malignant skin
tumors during recent years, and additional new
cytokines will be introduced in
skin cancer treatment in near future.