[Cytokines: current status and prospects in the treatment of skin tumors].
Various therapeutic options using cytokines have been described in the treatment of melanoma, T cell lymphoma, B cell lymphoma, squamous cell carcinoma, basal cell carcinoma and Merkel cell carcinoma. The treatment regimens include cytokine substitution, cytokine induction, cytokine transfection and therapeutic cytokine constructs. In the adjuvant treatment of melanomas, IFN-alpha has become well established. Statistical evaluations of different adjuvant trials show that a significant prolongation of recurrence-free intervals can be achieved. IL-2 has a role in the therapy of advanced melanomas as well as in vaccination strategies. Further possible therapeutic immune modulations, which have been evaluated in experimental approaches and pilot studies, include treatment with IL-4, IL-7 and GM-CSF. Treatment with IL-12 promises to open new perspectives. A well established regimen in the treatment of T cell lymphoma stages Ia-IIb is the combination of PUVA and IFN-alpha. In vitro data also indicate an important (patho)physiological role for IL-12, so that this agent has been tested in phase I studies. IL-2, IFN-gamma, and the fused cytokine-toxin molecules DAB389IL-2 offer further therapeutic alternatives. B cell lymphomas are treated with antibody-IL-2 fusion proteins. Advanced or inoperable squamous cell carcinoma and basal cell carcinoma may be treated with local IFN-alpha injections. IFN-alpha or TNF-alpha may be considered for the treatment of recurrent or advanced Merkel cell carcinoma. In dermatological oncology cytokine treatment focuses on melanome an T cell lymphome. Cytokine application is mainly an integral part of multimodal regimens.
Nashan
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Universitäts-Hautklinik Münster und Ludwig Boltzmann Institut für Zellbiologie und Immunbiologie der Haut.
Luger
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D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D015266:Carcinoma, Merkel Cell / Q000188:drug therapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D003131:Combined Modality Therapy; D016207:Cytokines / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007378:Interleukins / Q000627:therapeutic use; D008223:Lymphoma / Q000188:drug therapy*; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D016399:Lymphoma, T-Cell / Q000188:drug therapy; D008545:Melanoma / Q000188:drug therapy*; D008546:Melanoma, Experimental / Q000188:drug therapy; D051379:Mice; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011701:PUVA Therapy; D010166:Palliative Care; D012878:Skin Neoplasms / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use
D000970:Antineoplastic Agents; D016207:Cytokines; D016898:Interferon-alpha; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D016178:Granulocyte-Macrophage Colony-Stimulating Factor