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Soo Park, MD
Soo Park, MD
Posted: Thursday, February 1, 2024
An article published in Cancers presented an extensive review of neoadjuvant systemic therapies for patients with different types of non-melanoma skin cancers prior to surgical excision. Neil D. Gross, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues offered a guide for the current applications of neoadjuvant treatments in patients with basal cell carcinoma, cutaneous squamous cell carcinoma, Merkel cell carcinoma, and non-melanoma skin cancer. Based on their overall findings, the use of neoadjuvant immunotherapy drugs yielded the best results and may allow for surgical treatment of previously unresectable disease.
“Surgery and external-beam radiation therapy are the primary treatment modalities for locally advanced [non-melanoma skin cancer], but they can lead to impairment of function and disfigurement…. With the advent of targeted systemic therapies and immunotherapy, physicians have explored the ability to offer neoadjuvant therapy…to reduce surgically induced morbidity,” stated Dr. Gross and colleagues.
The authors compared results with immunotherapies vs neoadjuvant use of the same drugs for the different types of skin cancers. For basal cell carcinoma, the initial phase II ERIVANCE trial yielded an objective response rate of 31% and an imaging complete response rate of 6% when patients were administered the Hedgehog pathway inhibitor vismodegib. Neoadjuvant findings with the same drug revealed that 80% of patients had a downstaging of disease, with an objective response rate of 71% and an imaging complete response rate of 49%.
Initial findings with the immune checkpoint inhibitor cemiplimab-rwlc in patients with squamous cell carcinoma demonstrated an objective response rate of 44% with a complete response rate of 13%. Neoadjuvant use of cemiplimab yielded a pathologic complete response rate of 51% and a major pathologic response rate of 13%.
Disclosure: For full disclosures of the study authors, visit www.mdpi.com.
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