Valencia Thomas, MD

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.

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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

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Evolving Treatment Landscape of Advanced Non-Melanoma Skin Cancers

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