SKIN CANCERS

Genetic aberrations across cancer types were the driving force behind drug approvals in 2018.

Nikhil I. Khushalani, MD,&nbsp;discusses the role of adjuvant therapy in patients with melanoma across various subtypes, and also highlights melanoma trials ongoing at Moffitt Cancer Center.<br /> &nbsp;

Jeffrey Weber, MD, PhD, discussed the data in support of discontinuing treatment in melanoma and how to properly follow these patients after they go off treatment.<br /> &nbsp;

Robert Andtbacka, MD,&nbsp;discusses the current use of T-VEC in melanoma and future directions with this type of treatment.

Pembrolizumab has been granted an&nbsp;accelerated approval by the FDA as a treatment for&nbsp;adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma.

Precision medicine has produced some dramatic successes in patients with advanced cancer. With developments in molecular profiling, targeted therapies are being applied to multiple tumors, most notably in advanced melanoma, NSCLC, and several types of leukemia. Alison Schram, MD, and David M. Hyman, MD, point out the challenges in determining the proportion of patients who will benefit from receiving targeted therapies.

Danny Rischin, MD, MBBS,&nbsp;discusses the phase II activity with cemiplimab as a novel PD-1 inhibitor for patients with metastatic and locally advanced CSCC.

Patients with advanced basal cell carcinoma who experience progression on hedgehog pathway inhibitor therapy, or are intolerant to it, have no approved therapeutic options. An ongoing phase II study evaluating cemiplimab in this population may prove efficacious based on its activity in other advanced malignancies.

Findings of an&nbsp;analysis of patient-reported outcomes with avelumab in the JAVELIN Merkel 200 trial showed consistency of effectiveness in patients with&nbsp;metastatic Merkel cell carcinoma based on clinical and PRO endpoints.

Management of a Patient With a Very Large Ocular CSCC Tumor

A phase II trial is currently recruiting patients with Merkel cell carcinoma to participate in a single-arm study evaluating the safety and efficacy of INCMGA00012.¹The open-label, multicenter study seeks to enroll 90 patients, including at least 52 patients who are treatment-na&iuml;ve. In addition, only 40 patients who are chemotherapy-refractory will be allowed to participate

Cabozantinib demonstrated the strongest response observed to date among all the multikinase inhibitors that have shown activity in bone sarcoma, according to results from the CABONE trial that were reported at the 2018 CTOS Annual Meeting.

Danny Rischin, MD, MBBS, FRACP, discusses an ongoing phase III trial for patients with metastatic cutaneous squamous cell carcinoma or recurrent disease after progressing on frontline chemotherapy.&nbsp;

Hussein A. Tawbi, MD, PhD, discusses why melanoma responds so well to immunotherapy.

Hussein A. Tawbi, MD,&nbsp;discusses the expansion of the treatment armamentarium for adjuvant melanoma and the next steps with research in this patient population.<br /> &nbsp;

After decades of being considered the &ldquo;graveyard of drug development,&rdquo; melanoma has now become one of the hottest fields in oncologic research. In response to this rapid change in the treatment landscape, the Society for Immunotherapy of Cancer has issued updated consensus guidelines to help clinicians stratify patients, choose optimal treatment regimens, and manage immune-related adverse events in patients with stage II to IV disease.

An analysis of patients who presented to MD Anderson Cancer Center&rsquo;s dermatology clinic following treatment with anti&ndash;PD-1/PD-L1 treatment suggests a potential association between the development of cutaneous squamous cell carcinoma lesions and PD-1/PD-L1 checkpoint inhibition.

Cutaneous squamous cell carcinoma is the second most common form of skin cancer, with an estimated 1 million cases treated in the United States each year.&nbsp;Although most cSCCs are localized and can be easily treated, approximately 5% of patients will experience local recurrence, 4% will develop nodal metastases, and up to 2% will die of the disease.&nbsp;In addition to the small but significant number of deaths attributed to cSCC each year, the disease and its associated precancerous skin lesions contribute to a large financial burden of more than $4.5 billion annually in the United States.

Although it is the second most common form of skin cancer in the United States, cutaneous squamous cell carcinoma can often be effectively treated with a variety of surgical modalities, such as standard excision, Mohs micrographic surgery, curettage and electrodessication, and cryosurgery.

There has been a rapid expansion to the treatment landscape for adjuvant melanoma and there is no head-to-head comparative data for the challenge of selecting between immunotherapy and targeted therapy. When selecting a type of therapy, communicating relative merits and risks of both options to patients is necessary in making a shared decision, said&nbsp;Hussein Tawbi, MD, PhD.