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Soo Park, MD


Advanced Non-Melanoma Skin Cancer: Avoiding Surgery With Upfront Systemic and Radiation Therapies

By: Julia Fiederlein Cipriano, MS
Posted: Thursday, March 7, 2024

According to Soo Park, MD, of UC San Diego Moores Cancer Center, La Jolla, California, and colleagues, in select patients with advanced unresectable non-melanoma skin cancer who achieve a clear clinical response to upfront systemic therapy, consolidative radiation therapy appears to be a safe and effective strategy to avoid surgery. These findings from an ongoing retrospective cohort study, which were presented during the 2024 Multidisciplinary Head and Neck Cancers Symposium (Abstract 235), warrant long-term investigation.

“Checkpoint inhibitors and Hedgehog inhibitors have shown promising results for treatment of locally advanced [non-melanoma skin cancers] in the neoadjuvant setting,” the investigators commented. Thus, they evaluated the combination of upfront systemic therapy and consolidative radiation therapy in patients with cutaneous squamous cell carcinoma (systemic therapy: cemiplimab-rwlc, n = 7; pembrolizumab, n = 1), basal cell carcinoma (sonidegib, n = 7), and Merkel cell carcinoma (pembrolizumab, n = 2) who were anticipated to experience significant surgically related morbidity.

Based on physical examination, the complete clinical response rate was 100%. Five and two of the patients with available imaging achieved complete and partial radiographic responses, respectively. According to the investigators, to date, all who completed treatment remain in remission.

One patient with cutaneous squamous cell carcinoma who received cemiplimab developed hepatitis, which was resolved with immunosuppression; another treated with pembrolizumab developed mild dermatitis and colitis but did not require intervention. Three patients experienced toxicity with sonidegib, and thus the dosing frequency with this agent was reduced from daily to every other day.

Disclosure: For full disclosures of the study authors, visit

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