Biomarkers Predicting for Response and Relapse with Melanoma Systemic Therapy

Area of Science:

• Dermatology
• Surgical Oncology
• Medical Oncology

Background:

• Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer.
• Accurate staging and risk stratification are crucial for effective management.
• Treatment decisions for cSCC can be complex, especially in organ-transplant recipients.

Purpose of the Study:

• To provide comprehensive guidelines for the diagnosis and management of primary cutaneous squamous cell carcinoma.
• To define high-risk cSCC and outline appropriate treatment and follow-up strategies.
• To address specific considerations for cSCC in organ-transplant recipients.

Main Methods:

• Review of current literature and clinical guidelines for cSCC management.
• Emphasis on physical examination, including tumor diameter and lymph node assessment.
• Surgical resection with adequate margins as the primary treatment modality.

Main Results:

• Surgery with a 5-mm margin is the standard treatment for cSCC.
• Adjuvant radiation therapy is recommended for incomplete resections or high-risk features.
• Systemic treatment, including PD-1 inhibitors like cemiplimab, is indicated for advanced or unresectable cSCC.

Conclusions:

• Early detection and appropriate surgical intervention are key for favorable outcomes in cSCC.
• Risk stratification influences follow-up schedules, with less intensive surveillance for low-risk tumors.
• Management of cSCC in transplant patients requires careful consideration of immunosuppression.