As solid organ transplantation becomes more prevalent, more individuals are living as members of the immunosuppressed population with an elevated risk for cutaneous squamous cell carcinoma (cSCC). Although great progress has been made in understanding the pathogenesis of cSCC in general, little is known about the drivers of tumorigenesis in immunosuppressed patients and organ-transplant recipients, specifically. This systematic review sought to synthesize information regarding the genetic and epigenetic alterations as well as changes in protein and mRNA expression that place this growing population at risk for cSCC, influence treatment response, and promote tumor aggressiveness. This review will provide investigators with a framework to identify future areas of investigation and clinicians with additional insight into how to best manage these patients.
Keywords: 6-TG, 6-thioguanine; AZA, azathioprine; CNI, calcineurin inhibitor; CsA, cyclosporine; ICP, immunocompetent patient; ISP, immunosuppressed patient; NMSC, nonmelanoma skin cancer; OTR, organ-transplant recipient; RTR, renal transplant recipient; SCC, squamous cell carcinoma; STAT, signal transducer and activator of transcription; TAK1, TGFβ-activated kinase 1; VNO, voriconazole-N-oxide; cSCC, cutaneous squamous cell carcinoma; hBD, human β-defensin; miRNA, microRNA; p-Smad, phosphorylated Smad.
© 2022 The Authors. Published by Elsevier, Inc. on behalf of the Society for Investigative Dermatology.