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Over 50% of all melanoma diagnoses among White patients in the United States may in fact be overdiagnoses, according to a recent study published by Adamson et al in BMJ Evidence-Based Medicine. Background “Cases of cutaneous melanoma have risen significantly in the [United States] over the last 40...
A recent study underscored the need for integrating cost-of-care conversations in cancer treatment. Results of the population-based analysis, presented at the 2023 ASCO Quality Care Symposium,1 showed that only about 25% of patients with newly diagnosed advanced non–small cell lung cancer (NSCLC)...
A rare subset of T cells called V-delta 1 gamma-delta (Vd1-gd) T cells could help predict which patients with advanced skin cancer may be responsive to immunotherapy, according to a novel study published by Davies et al in Nature Cancer. The new findings may lead to the development of new and more...
This is Part 4 of Evolving Skin Cancer Management, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Pauline Funchain, Alison Vidimos, and Lisa Zaba review the case of a 32-year-old patient who recently gave birth to her first child; following childbirth, she noticed a suspicious lesion on her thigh. A biopsy confirms that the lesion is a melanoma, with a Breslow depth of 3 mm. In the conversation that follows, the faculty note the rising incidence of skin cancer in people younger than 40, including melanoma, and also point out skin changes during pregnancy that may warrant surveillance in the perinatal and postnatal periods. They also discuss the debate surrounding the role of prognostic gene expression profiling in this patient population.
This is Part 3 of Evolving Skin Cancer Management, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Pauline Funchain, Alison Vidimos, and Lisa Zaba discuss the importance of early detection and multidisciplinary treatment of Merkel cell carcinoma. The patient is a 72-year-old male with a history of extensive sun exposure. He presents with a rapidly growing, firm—but painless—1.5 cm nodule on the back of his hand. In the conversation that follows, the faculty emphasize the importance of early detection and timely diagnosis of Merkel cell carcinoma due to its aggressive natural history, rapid growth, and lack of distinguishing clinical features; touch on the multidisciplinary collaboration between dermatology, surgery, and oncology necessary for optimal care; and discuss upcoming data on the role of adjuvant immunotherapy for this malignancy.
This is Part 2 of Evolving Skin Cancer Management, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Pauline Funchain, Alison Vidimos, and Lisa Zaba review how the multidisciplinary team comes together to treat cutaneous squamous cell carcinoma. The patient is a 65-year-old man with a history of long-term sun exposure and has had multiple actinic keratoses. He presents to dermatology with a large, aggressive cutaneous squamous cell carcinoma on his cheek; it is approximately 4 cm. He also has a history of chronic lymphocytic leukemia, for which he is undergoing observation. In the conversation that follows, the faculty discuss how a multidisciplinary team of practitioners may come together to care for this patient, and discuss if and when they would consider treatment options such as surgery, radiation, and systemic therapy.
This is Part 1 of Evolving Skin Cancer Management, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Pauline Funchain, Alison Vidimos, and Lisa Zaba discuss nonsurgical treatment options for basal cell carcinoma. The patient is a 68-year-old female who presents with a 1.5 cm nodular lesion on her nose. A biopsy shows that the lesion is indeed a basal cell carcinoma, with no signs of aggressive growth or invasion. The patient is concerned about undergoing surgery due to the risk of facial scarring and wants to know more about alternative, nonsurgical treatment options. In the conversation that follows, the faculty discuss nonsurgical options for patients with basal cell carcinoma, including photodynamic therapy, laser therapy, topical agents, hedgehog inhibitors, immunotherapy, and more.
For the treatment of advanced melanoma that is refractory to anti–PD-1 antibodies, there is no standard approach. The various options, with a look to the future, were discussed by Melinda L. Yushak, MD, MPH, Assistant Professor of Hematology and Oncology at Emory University School of Medicine, at...
Individuals who experience occupational exposure to solar ultraviolet (UV) radiation may have a high rate of nonmelanoma skin cancer incidence and mortality, according to a recent study published by Pega et al in Environment International. These findings highlighted the large and increasing burden...
The risk of developing skin cancer may be twofold for patients with lymphedema, according to a recent study published by Anand et al in Mayo Clinic Proceedings. The new findings may contribute to growing information linking lymphedema to localized changes in immunity and a predisposition for...
In an analysis presented at the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract LBA50) and reported in The New England Journal of Medicine by Jessica C. Hassel, MD, and colleagues, overall survival at 3 years in the phase III IMCgp100-202 trial continued to favor...
Investigators have uncovered that only about 25% of patients newly diagnosed with advanced cancer have documented physician discussions about the costs of care, which may make it more difficult to identify patient needs and track the outcomes of referrals for assistance, according to new findings...
In exploratory analyses of results from the SWOG S1801 trial in patients with stage III to IV resectable melanoma, researchers saw a major pathologic response in more than half of surgical specimens taken from patients who had been treated with neoadjuvant pembrolizumab. These and other results of...
At the European Society for Medical Oncology (ESMO) Congress 2023, new findings are being presented in cutaneous squamous cell carcinoma, late-stage melanoma, and refractory melanoma brain metastases. Presurgical Immunotherapy in Advanced Operable Cutaneous Squamous Cell Carcinoma Patients with...
On October 13, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) for the adjuvant treatment of completely resected stage IIB or IIC melanoma in patients aged 12 years and older. CheckMate 76K Efficacy was evaluated in CheckMate 76K (ClinicalTrials.gov identifier NCT04099251),...
A novel artificial intelligence (AI) software may be effective in detecting skin cancer and precancerous lesions, according to findings presented by Andrew et al at the European Academy of Dermatology and Venereology Congress 2023. Background Skin cancer detection using AI software has rapidly...
Nonmelanoma skin cancer may be causing a greater number of global deaths than melanoma, according to findings presented by Salah et al at the European Academy of Dermatology and Venerology Congress 2023. Investigators also suggested that nonmelanoma skin cancer may be underreported and that the...
A guideline update on systemic treatment for melanoma offers new guidance in several areas, including the selection of front-line therapy for patients with metastatic disease with and without BRAF mutations, treatment of patients with earlier-stage disease in the adjuvant setting, and emerging...
On August 14, 2023, the Hepzato Kit—melphalan for injection/hepatic delivery system—was approved as a liver-directed treatment for adults with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver.1 Patients must have either no extrahepatic disease or extrahepatic ...
Neoadjuvant immunotherapy may be effective prior to surgery in multiple types of cancers, according to a recent study published by Topalian et al in Cancer Cell. Background Neoadjuvant immune checkpoint blockades have been a rapidly growing area of research and are currently being tested across...
Investigators have discovered that significantly higher levels of endocrine-disrupting chemicals such as per- and poly-fluoroalkyl substances (PFAS) and phenols may be present in patients with breast, ovarian, skin, and endometrial cancers, according to a recent study published by Cathey et al in...
Researchers have discovered that the combination of the CTLA-4 inhibitor ipilimumab and the PD-1 inhibitor nivolumab may be an effective second-line therapy in patients with PD-1 blockade–refractory metastatic melanoma, according to a recent study conducted by the SWOG Cancer Research Network and...
In the phase III PIVOT IO 001 trial reported in the Journal of Clinical Oncology, Adi Diab, MD, and colleagues found that the addition of bempegaldesleukin, a pegylated interleukin-2 cytokine prodrug, to nivolumab did not improve treatment outcomes in previously untreated patients with advanced...
In patients with melanoma who are undergoing neoadjuvant therapy with immune checkpoint blockade, response to treatment may guide the intensity of additional treatment, according to a retrospective analysis of two major trials presented by Irene L.M. Reijers, an MD/PhD candidate in the Christian...
Investigators in Canada may have uncovered the factors contributing to the higher risk of melanoma among individuals living in Atlantic regions, according to a recent study published by Lagacé et al in Cancers. These findings may provide insights into effective strategies for skin cancer...
In a retrospective cohort study reported in JAMA Network Open, Goodman et al found that patients receiving adjuvant PD-1 inhibitor therapy for high-risk resected melanoma often had chronic immune-related adverse events, with some persisting over long-term follow-up. Study Details The study included ...
As reported in a research letter in JAMA Oncology by Reinhard Dummer, MD, and colleagues, the final, 5-year analysis of a phase II trial showed continued improvement in outcomes with the addition of neoadjuvant talimogene laherparepvec (T-VEC) to surgery in patients with advanced melanoma. Study...
Researchers have discovered that ipilimumab in combination with nivolumab may be an effective second-line therapy in patients with PD-1 blockade–refractory metastatic melanoma, according to a recent study published by VanderWalde et al in Nature Medicine. These findings demonstrated the combination ...
On August 14, the U.S. Food and Drug Administration (FDA) approved the HEPZATO KIT, a melphalan hepatic delivery system, as a liver-directed treatment for adult patients with metastatic uveal melanoma and unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic...
In part 2 of a phase III trial (COLUMBUS) reported in the Journal of Clinical Oncology, Paolo A. Ascierto, MD, and colleagues found evidence that MEK inhibition contributed to positive outcomes with combination BRAF/MEK inhibitor therapy in advanced BRAF V600–mutant melanoma. Study Details As...
Increased skin cancer screenings may not reduce disparities in the survival rates of patients with melanoma who have darker skin tones, according to a recent study published by Smith et al in JAMA Dermatology. Background Although melanoma—the leading cause of skin cancer mortality—is most common...
A revised report of findings from the phase II TRICOTEL study of atezolizumab, vemurafenib, and cobimetinib in patients with melanoma and central nervous system (CNS) metastases was published in The Lancet Oncology by Reinhard Dummer, MD, and colleagues. The first version of trial findings,...
As reported in The Lancet by Becker et al, an interim analysis of a European phase II study (ADMEC-O) showed that adjuvant nivolumab was associated with a numeric benefit in disease-free survival vs observation in patients with completely resected Merkel cell carcinoma. Study Details In the...
Investigators have discovered that cetuximab in addition to concurrent radiotherapy may be safe and effective at treating patients with locally advanced cutaneous squamous cell carcinoma, according to a recent study published by Chang et al in Oncotarget. Treatment for locally advanced cutaneous...
Researchers have found that fecal microbiota transplants from healthy donors may be safe and show potential in improving response rates to immunotherapy in patients with advanced melanoma, according to a phase I study published by Routy et al in Nature Medicine. Background While immunotherapy...
As reported in the Journal of Clinical Oncology by Caroline Robert, MD, PhD, and colleagues, the 7-year follow-up of the phase III KEYNOTE-006 trial has shown a continued overall survival benefit with pembrolizumab vs ipilimumab in patients with advanced melanoma. The primary analysis of the trial...
The combination of curettage and cryosurgery may be a safe and effective treatment method for patients with basal cell carcinoma, according to a novel study published by Backman et al in the Journal of the American Academy of Dermatology. Background The incidence of skin cancer is continuing to...
The formal discussant of the phase II SWOG S1512 trial was Zeynep Eroglu, MD, of the Department of Cutaneous Oncology at the Moffitt Cancer Center in Tampa, Florida. She congratulated Dr. Kendra and her coauthors for conducting a study in such a rare tumor. “I think we can say desmoplastic melanoma ...
The immune checkpoint inhibitor pembrolizumab achieved high response rates in patients with unresectable metastatic desmoplastic melanoma, a rare invasive tumor type, according to the results of the phase II SWOG S1512 trial presented at the 2023 American Association for Cancer Research (AACR)...
In the phase IIIb CheckMate 401 trial reported in the Journal of Clinical Oncology, Reinhard Dummer, MD, and colleagues described outcomes with first-line nivolumab/ipilimumab followed by nivolumab in a clinically diverse population of patients with unresectable stage III or IV melanoma, including...
Shailender Bhatia, MD, of the University of Washington and Fred Hutchinson Cancer Center, discusses phase I/II results on the efficacy of nivolumab with or without ipilimumab in patients with recurrent or metastatic Merkel cell carcinoma. The study found that, for this rare and aggressive skin cancer, nivolumab showed clinical activity in advanced disease. However, these results from CheckMate 358 do not suggest an additional benefit with ipilimumab added to nivolumab (Abstract 9506).
The rates of survival and disease recurrence improved significantly when a personalized mRNA vaccine tailored to the patients’ tumor genetics was coupled with immunotherapy in those who had undergone surgery for high-risk melanoma, according to novel findings presented by Khattak et al at the 2023...
In a single-institution study conducted in New Zealand reported in JAMA Surgery, Goh et al found that microdoses of incisional antibiotics may reduce the risk of surgical site infections during surgery for skin cancer, as well as reduce the risk of infections requiring postoperative systemic...
Allison Betof Warner, MD, PhD, of Stanford University Medical Center, and Zeynep Eroglu, MD, of H. Lee Moffitt Cancer Center and Research Institute, discusses phase II findings showing that in patients with BRAF-mutant metastatic melanoma, dabrafenib plus trametinib and navitoclax (DTN) was associated with a complete response rate of 20% and an overall response rate of 84%. Additionally, there was a trend toward improved overall survival in patients treated with DTN compared with dabrafenib plus trametinib alone; the difference in overall survival was more pronounced in patients with a smaller tumor burden (Abstract 9511).
Jason J. Luke, MD, of the University of Pittsburgh Medical Center Hillman Cancer Center, discusses adjuvant pembrolizumab, which, in previous results, improved distant metastasis– and recurrence-free survival in patients with resected stage IIB or IIC melanoma vs placebo. After a median follow-up of 39.4 months, adjuvant pembrolizumab continued to show a benefit over placebo, with no new safety signals (Abstract LBA9505).
Allison Betof Warner, MD, PhD, of Stanford University Medical Center, and Adnan Khattak, MBBS, FRACP, PhD, of Australia’s Hollywood Private Hospital & Edith Cowan University, discuss the use of the mRNA-4157 vaccine in combination with pembrolizumab as adjuvant therapy for resected high-risk melanoma, which prolonged distant metastasis–free survival compared with pembrolizumab alone. These results provide further evidence that a personalized neoantigen approach is potentially beneficial (Abstract LBA9503).
Georgina V. Long, MD, PhD, of Melanoma Institute Australia and The University of Sydney, discusses new data showing that patients with resected stage IIB/C melanoma who were treated with adjuvant nivolumab had prolonged recurrence-free survival compared with placebo across all biomarker subgroups. The baseline biomarkers most predictive of prolonged recurrence-free survival with nivolumab were high interferon gamma score, high tumor mutational burden, CD8 T-cell infiltration, and low C-reactive protein (Abstract 9504).
Omid Hamid, MD, of The Angeles Clinic & Research Institute, discusses study findings on fianlimab plus cemiplimab-rwlc, which showed clinical activity in patients with advanced melanoma, comparing favorably with other approved combinations of immune checkpoint inhibitors in the same clinical setting. This is the first indication that dual LAG-3 blockade may produce a high level of activity with significant overall response rate after adjuvant anti–PD-1 treatment. A phase III trial of this regimen in treatment-naive patients with advanced melanoma is ongoing (Abstract 9501).
In a small study reported in JAMA Network Open, D’Andrea et al found that diffusing alpha-emitter radiation therapy—a novel solid tumor management strategy using alpha-particle interstitial brachytherapy—appeared to be safe and showed activity in patients with recurrent or unresectable skin...
Caroline Robert, MD, PhD, Head of the Dermatology Unit at Gustave Roussy and Co-Director of the Melanoma Research Unit at INSERM 981 Paris-Sud University, was born and reared in Paris. “I didn’t have a vocation for medicine when I was a kid; I wanted to be an archeologist. I’m not from a medical...