Valencia Thomas, MD

Valencia D. Thomas, MD, MHCM, professor in the Department of Dermatology, Division of Internal Medicine, MD Anderson Cancer Center, discusses the unmet needs which remain in the non-melanoma skin cancer space.

The most common types of non-melanoma skin cancers include Basal cell carcinoma, Merkel cell carcinoma, and squamous cell carcinoma. While these cancer types have been met with many new developments in the last 10 years, a need remains for more FDA approved drugs for patients with rare tumor types.

In a session at National Comprehensive Cancer Network (NCCN) Annual Meeting 2022, Thomas discussed advanced or aggressive non-melanoma skin cancers that came back after their first treatment as well as those which began in an advanced detection.

While there are various treatment options available for this patient population, including surgical treatments, radiation, and systemic options, Thomas notes that more research needs to focus on treatment which may provide positive opportunities and lead to a cure for these patients.

Although we have come a long way over the last 10 years, the needs we have are to further gather information for the rare tumor type, to have FDA approved medications for some of these rare tumor types, and to further expand the use of immunotherapy to rare tumors.

We use what is currently available to the best of our abilities. As innovative technologies and therapies become more available, we start with what is most common. Then we must move towards what is less common to get the same body of data and information so that we can give the same outcome to aggressive tumors that may not be as common.

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Valencia D. Thomas, MD, MHCM, discusses the unmet needs which remain in the non-melanoma skin cancer space.


More FDA Approved Treatments are Needed for Non-Melanoma Skin Cancers

Valencia Thomas, MD, MHCM, Department of Dermatology, Division of Internal Medicine, MD Anderson Cancer Center, discusses the future for managing care in patients with non-melanoma skin cancers.

Within the previous years, updates in technology and research have allowed for the development of new therapies to improve the prognosis of patients with non-melanoma skin cancers. For patients with advanced disease, highly aggressive disease, and disease with distant metastases, current viable options include immunotherapy, medications, surgical intervention, radiation, chemotherapy, and more.

Thomas notes that the future is bright for this patient population and might include collaboration between various medical specialties, new and innovative applications of currently existing therapies, improvements in surveillance, and increased education for both patients and providers.

 The future for the management of non-melanoma skin cancers includes close collaboration between different medical specialties so that the best of each specialty is leveraged in the fight against cancer. What we're seeing moving forward are innovative applications of currently existing therapeutics to address cancers that have historically had poor outcomes or cancers that are very difficult to fight, because our detection is limited. The good news about skin cancer is that with skin cancers, we have a shot at having a sign or a symptom that is there, so making sure that we improve our surveillance, making sure we improve the education of both providers and patients. We can help to intervene at an earlier level.

When I look at the future, I look at the wonderful efforts that are made to educate using technology, using social media to help people identify what is abnormal, but then the future allows us the opportunity to really collaborate and speak.

Valencia Thomas, MD, MHCM, MD Anderson Cancer Center, discusses the future for managing care in patients with non-melanoma skin cancers.

Future Directions for the Management of 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.

 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.

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.

 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.

Valencia Thomas, MD, MHCM, discusses how the management of care for patients with non-melanoma skin cancers has changed over the past decade.

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 the current landscape regarding non-melanoma skin cancers.

Non-melanoma skin cancers affect millions of individuals each year with some of the most common consisting of Basal cell carcinoma, Merkel cell carcinoma and squamous cell carcinoma, according to Thomas. However, a lot of time and focus is projected on the management of squamous cell carcinoma as it results in high amounts of morbidity.

At the recent National Comprehensive Cancer Network Annual Meeting, Thomas along with other experts ran a session on managing patients with aggressive non-melanoma skin cancers. The session highlighted a variety of the recent innovations in the management of non-melanoma skin cancers as well as common or uncommon tumors as well.

 We focus our session on the advanced or aggressive non melanoma skin cancers that either didn't read the book and stay gone once they were treated the first time, or the ones that started off in an advanced detection. For example, 25-35% of Merkel cell carcinomas are already present in the lymph node at the time of biopsy. Even though some of these cancers are rare or aggressive, we have multiple treatment options, multiple different surgical treatment options, radiation options, and systemic options that either alone or when combined can give patients a wonderful opportunity for cure.

Valencia Thomas, MD, MHCM, discusses the current landscape regarding non-melanoma skin cancers.

Valencia Thomas, MD | Authors

Articles

More FDA Approved Treatments are Needed for Non-Melanoma Skin Cancers

Future Directions for the Management of Non-Melanoma Skin Cancers

Evolving Treatment Landscape of Advanced Non-Melanoma Skin Cancers

Current Options for Treating Non-Melanoma Skin Cancers