What Are Some Other Methods To Manage Skin Cancer Outside of Biopsies?

At the 44th Annual Fall Clinical Dermatology Conference in Las Vegas, a talk titled ‘Beyond the Biopsy: Other Methods To Help Us Manage Skin Cancer’ was given by 2 presenters: Neal Bhatia, MD, and Laura Korb Ferris, MD, PhD.

Ferris is a professor at the University of Pittsburgh Clinical and Translational Science Institute and the director of the clinical trials unit at the UPMC department of dermatology. Bhatia serves as director of clinical dermatology at Therapeutics Clinical Research and chief medical editor for Practical Dermatology.

“We really covered the gamut of treatment options, so everything from topical therapy, intralesional therapy to systemic therapy,” Ferris explained. “We talked about data that exists right now, and also some interesting trials and data to come.”

Bhatia added that the talk’s goal was to remind dermatologists that they need to be involved in every step, rather than simply allowing the oncologist to take over severe tumors. The 2 clinicians were asked about therapies highlighted in the talk.

“So we talk a little bit about topical 5-Fluorouracil and as well as imiquimod, going over a little bit of data and thinking about treatment,” Ferris said. “...I think really, 2 of the biggest advancements that we have had have been the hedgehog inhibitors sonidegib and vismodegib for basal cell carcinomas, and then cemiplimab for the treatment of squamous cell carcinomas.”

Bhatia agreed, adding that the key was to remind dermatologists that these are drugs for dermatologists and not for oncologists exclusively. He noted that being comfortable with managing adverse events was important.

“We talk about some strategies for hedgehog inhibitor side effects,” Bhatia explained. “L-carnitine, for example, and watching the lipids, fish oil, things like that for therapy. But also, again, reminding about some implement and checkpoint inhibitors. Remembering that there's so many cutaneous adverse events that dermatologists have to stay involved with those patients who are getting them, even if we're not the ones doing the infusion.”

Ferris noted that the most challenging adverse events for patients can be muscle spasms and loss of taste, though she also highlighted weight loss, hair loss, and electrolyte abnormalities. She added that these events are often reasons why patients discontinue.

“Yeah, the adverse event profile check inhibitors is very broad, especially simple eruptions that look like acne, different kind of hypersensitivity rashes or even infusion side reactions, ranging all the way to full blown DRESS syndrome and even anaphylaxis,” Bhatia said. “Obviously that is in really rare cases. But a lot of the checkpoint inhibitor effects can be somewhat dose-limiting when they're not recognized by dermatologists.”

He added that 1 of the articles they quote highlights why dermatologists should be involved in the development of these drugs so that adverse event profile reporting is accurate. Bhatia noted that, unfortunately, a lot of the oncologists may not recognize certain outcomes which are skin-related.

For further information on this topic, view the full interview segment with Bhatia and Ferris posted above. To learn more about information covered at the conference, check out the latest coverage of Fall Clinical here.

The quotes used in this interview summary were edited for the purposes of clarity.