# Skin Cancer Metabolic Profile Assessed by Different Analytical Platforms
## 8 Clinical Implications of the Metabolic Profile of Skin Cancer  
There is a wide range of approaches for treating skin cancer, including excision, radiation therapy, cryosurgery, electrodesiccation, and curettage and immunotherapy (PD-1 inhibitors) [69]. However, treatment may often result in undesired long-term side effects, like fatigue and increased risk of cardiovascular diseases and cardiotoxicity [70]. \begin{table}
\begin{tabular}{c c c} \hline \hline
**Groups** & & **Metabolomics Signatures** \\ \hline \multirow{3}{*}{I} & & \(\bullet\) & Eight metabolites were recognized and validated. \\  & & \(\bullet\) & The concentrations of glutamine, tyrosine, aspartate, creatinine, valine, \\  & & \(\bullet\) & alanine and lactate were significantly increased in SCCs group compared to controls. \\  & & \(\bullet\) & The concentration of glucose was significantly decreased in SCCs group compared to controls. \\ \hline \multirow{3}{*}{II} & & \(\bullet\) & Four metabolites were identified and validated. \\  & & \(\bullet\) & The concentrations of aspartate, valine, lactate and alanine were \\  & & \(\bullet\) & significantly elevated in peri-tumoral regions compared to controls. \\ \hline \multirow{3}{*}{III} & & \(\bullet\) & Four metabolites were identified and validated. \\  & & \(\bullet\) & The concentrations of aspartate and phenylalanine were significantly \\  & & \(\bullet\) & elevated in peri-tumoral regions compared to SCCs \\  & & \(\bullet\) & The concentrations of isoleucine and methanol were significantly \\  & & \(\bullet\) & diminished in peri-tumoral regions compared to SCCs. \\ \hline \multirow{3}{*}{IV} & & \(\bullet\) & 11 metabolites (methanol, glutamine, tyrosine, aspartate, phenylalanine, \\  & & \(\bullet\) & creatinine, alanine, lactate, isoleucine, valine, and glucose) were identified \\  & & \(\bullet\) & to be significant among all the three groups. \\ \cline{1-1}  & & \(\bullet\) & 3 of them (valine, lactate, and alanine) involved in peri-tumoral zones \\ \cline{1-1}  & & \(\bullet\) & and SCCs were recognized as the main affected metabolites. \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Study findings. Importantly in some cases, tumor cells develop resistance to therapy representing a major drawback in the success of skin cancer treatment [71]. The Food and Drug Administration (FDA) has approved two PD-1 inhibitors, cemiplimab and pembrolizumab, as systemic therapies for recurrent or metastatic skin cancer. Each of these treatments not only has a low success rate, but also has associated side effects such as toxicity and death [72]. As a result, the biomedical community must urgently create reliable and precise biomarker profiles to assess and monitor therapy responses in skin cancer patients [73]. The metabolic profile of skin cancer has several clinical implications, such as improving the clinical practice using disease metabolomics data by clinicians as a diagnostic, prognostic and monitoring tool for skin cancer, and confirming to clinicians how successful treatments are for the management of patients with skin cancer by tracking patients' therapy responses routinely. Clinical impacts also involve showing molecular basis of cancer development and progression in addition to identifying new candidate biomarkers, allowing for the development of more effective, tailored anticancer therapy. Although metabolomics can be used to track a treatment, metabolite levels on their own provide a snapshot of the metabolism at the time of collection. To anticipate the result of skin cancer immunotherapy and provide information on treatment efficacy, while tracking toxicity levels, it is therefore required to supplement this information with metabolic pathway dysregulation and other omics changes. However, melanoma is a remarkably heterogeneous tumor type that significantly varies from patient to patient.