Experts explore the optimal sequencing of immunotherapy relative to radiation therapy in CSCC and BCC care.
This is a video synopsis/summary of a Peer Exchange involving Jason Luke, MD, FACP; Christopher Barker, MD; Omid Hamid, MD; Vishal Patel, MD; and Catherine Pisano, MD.
Barker explained that immunotherapy is currently FDA-approved and standard of care for advanced cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) when surgery or radiation are no longer options. He stated radiation is sometimes used to palliate symptoms in immunotherapy nonresponders. Regarding integration with curative-intent radiation, he noted that in cSCC, immunotherapy is being studied adjuvant to surgery and radiation, not concurrently, based on success in this sequencing for non–small cell lung and gastroesophageal cancers. He contrasted this with failed trials combining immunotherapy and definitive chemoradiation for head and neck squamous cell carcinoma and other diseases. However, Barker suggested neoadjuvant immunotherapy prior to intense, definitive radiation could be explored in unresectable cSCC. Luke questioned whether smaller radiotherapy fields in skin cancer may better enable combinations with immunotherapy. Barker agreed that in advanced cSCC with both palliative and systemic therapy indications, concurrent radiation and immunotherapy out of clinical necessity may be reasonable.
Video synopsis is AI-generated and reviewed by AJMCÒ editorial staff.
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