Remodeling Methods of TIME for Enhanced Immunotherapy against Non-Melanoma Skin Cancer

Non-melanoma skin cancer is a serious malignancy and white-skinned people are highly susceptible to this cancer. About 918 deaths occurred due to NMSC in the UK following the year 2018-2019. The incidence of NMSC is 18-20 times higher as compared to melanoma skin cancer. The tumor immune microenvironment of NMSC possesses a diversity of immune cells that exert pro-tumor and anti-tumor effects on the TIME. So by recognizing the tumor-promoting entities, the TIME can be remodeled. Immunotherapy provides such a treatment that activates the person’s immune system to fight against tumorigenic cells. Radiotherapy also causes the modulation of the immune system and increases the anti-tumor responses in patients. The use of immune checkpoint inhibitors after radiotherapy has produced significant survival rates in patients. Oncolytic virus therapy is a subtype of immunotherapy with a positive response in the treatment of cancer. The synthetic viral promoter is highly specific to tumor and the introduction of transgenes help them to inhibit the tumor-promoting cells and make the tumor susceptible to anti-tumor cells, thus helping the tumor to eliminate from the body. This characteristic of oncolytic virus converts the ‘‘cold TIME’’ to ‘‘hot TIME’’ which exerts a highly positive response when used ICIs. In this article, a literature review is conducted to study the role of TIME in the progression of cancer and various methods that remodel the TIME such as immunotherapy, radiotherapy, and oncolytic viruses that might help to treat NMSC.