Evolving Treatment Landscape of Advanced Non-Melanoma Skin Cancers

Valencia Thomas, MD, MHCM, Department of Dermatology, Division of Internal Medicine, MD Anderson Cancer Center, discusses how the management of care for patients with non-melanoma skin cancers has changed over the past decade.

Improvements in technology, research, and therapies have helped improve the prognosis of patients with non-melanoma skin cancers, including advanced disease, highly aggressive disease, and disease with distant metastases.

There are a variety of new and innovative options for patients with advanced stage non-melanoma skin cancers to choose from. Immunotherapy, medications to aid the body’s immune system, surgical intervention, radiation, chemotherapy, targeted therapies are all potential options for use in this patient population.

Transcription:

0:08 | The management of non-melanoma skin cancer has evolved over the years because with every year that passes, we integrate innovations in technology, in pharmaceuticals, and in epidemiology where we have more data to help guide our treatment than 10 years ago. Certain tumors that were at an advanced stage had a prognosis that was very grim for advanced disease and disease with distant metastases.

0:45 | When we look at these highly aggressive advanced stage non-melanoma skin cancers, a lot of the landscape has changed with the advent of immunotherapy. There are many different medications that are now available that aid the body's immune system in detecting and defeating skin cancers. When combined with some of our traditional therapies and our traditional intervention, both surgical and radiation, we can get to an unexpected outcome compared to what we were seeing 10 years ago. Whereas surgery and radiation were sometimes the best option, now we're seeing situations where a little bit of medicine, some of our targeted therapy or chemotherapy options plus or minus radiation, are really changing the landscape.

1:55 | We're getting much better at targeting diseases. For example, a subtype of sarcoma, dermatofibrosarcoma protuberans, has a targeted therapy that attacks the mutation that is present in over 90% of the sarcomas, where a growth factor is next to a collagen team, to the cells that make the collagen grow. Only those cells are affected when the medication is given. Instead of having the chemotherapy of yesteryear that made many people sick, we now have chemotherapy and targeted therapy that can target only the tumor and give us wonderful outcomes. That cancer becomes a chronic disease rather than a fatal disease.