Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android



  • Immunomodulators are increasingly prevalent in treatment regimens for aggressive and recurrent melanoma and nonmelanoma skin cancers.

  • Checkpoint inhibitors, recombinant cytokines, oncolytic viruses, and gene therapies are various forms of immunotherapy that target single pathways to amplify immune surveillance of cancer cells.

  • Patients with advanced skin cancers have shown significant improvement in survival and tumor regression with these novel therapies.


  • The decision to treat advanced skin cancer with immunotherapy should be based on a patient-centered multidisciplinary approach.

  • Combination immunotherapies have been effective in treating advanced melanoma, but further data are needed to evaluate alternative regimens for nonmelanoma skin cancers.


  • Immunotherapy dosing for the pediatric population and a handful of adult regimens should be based on the patient’s weight. Doses should be delayed or modified for moderate adverse reactions and omitted for toxicity.


  • Patients and caregivers should be educated that frequently reported side effects of immunotherapy are fatigue, diarrhea, and rash. However, immune-mediated reactions, including colitis, endocrinopathies, and hepatotoxicity, are not uncommon. Patients should also be cautioned that many adverse reactions are still being discovered for these novel therapies.


Targeted immunotherapy is revolutionizing treatment for advanced melanoma and nonmelanoma skin cancers that cannot be managed with surgical or radiotherapeutic techniques. These therapies act by modulating a single pathway to prevent tumor evasion of immune surveillance without attacking healthy cells (Table 47-1).1 Skin cancers are highly sensitive to immunotherapy due to tumor-associated antigens, mutations, and viral gene expression.2 Checkpoint inhibitors, recombinant cytokines, oncolytic viruses, and gene therapies have been extensively studied to revert the repression of the host’s immune system that is caused by cancer cells.3 Novel therapies have demonstrated high durable response rates, prolonged progression-free survival, and overall survival benefit, along with a wide range of adverse events.

TABLE 47-1List of Immunomodulators of Skin Cancer

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.