The Immune Microenvironment in Basal Cell Carcinoma

Catherine Zilberg; James Guy Lyons; Ruta Gupta; Diona Lee Damian

doi:10.5021/ad.22.042

The Immune Microenvironment in Basal Cell Carcinoma

Ann Dermatol. 2023 Aug;35(4):243-255. doi: 10.5021/ad.22.042.

Authors

Catherine Zilberg¹, James Guy Lyons^{2

3}, Ruta Gupta^{4

5}, Diona Lee Damian^{2

6}

Affiliations

¹ Department of Dermatology, The University of Sydney at Royal Prince Alfred Hospital, Sydney, Australia. czil3665@uni.sydney.edu.au.
² Department of Dermatology, The University of Sydney at Royal Prince Alfred Hospital, Sydney, Australia.
³ Centenary Institute, The University of Sydney, Sydney, Australia.
⁴ Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, Australia.
⁵ Sydney Medical School, The University of Sydney, Sydney, Australia.
⁶ Melanoma Institute Australia, Sydney, Australia.

Abstract

The immune system plays a key role in the suppression and progression of basal cell carcinoma (BCC). The primary aetiological factor for BCC development is exposure to ultraviolet radiation (UVR) which, particularly in lighter Fitzpatrick skin types, leads to the accumulation of DNA damage. UVR has roles in the generation of an immunosuppressive environment, facilitating cancer progression. Rates of BCC are elevated in immunosuppressed patients, and BCC may undergo spontaneous immune-mediated regression. Histologic and immunohistochemical profiling of BCCs consistently demonstrates the presence of an immune infiltrate and associated immune proteins. Early studies of immune checkpoint inhibitors reveal promising results in BCC. Therefore, the host immune system and tumor responses to it are important in BCC pathogenesis. Understanding these interactions will be beneficial for disease prognostication and therapeutic decisions.

Keywords: Basal cell; Carcinoma; Neoplasms; Skin neoplasms; Tumor-infiltrating lymphocytes.

Publication types

Review