Management of Advanced Non-Surgical and Metastatic Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma

The presentation focuses on the management of advanced non-surgical and metastatic basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (CSCC), highlighting non-invasive treatments and the private practice perspective. Todd Schlesinger discusses the need for effective management strategies for inoperable tumors, particularly through immunotherapy and hedgehog pathway inhibitors. He shares experiences with patients who have had extensive sun exposure and multiple skin cancers, detailing cases where treatments like acetratin led to significant tumor regression. The efficacy of immunotherapy, including drugs like pembrolizumab, is emphasized alongside the importance of multidisciplinary collaboration in treatment planning. The National Comprehensive Cancer Network (NCCN) guidelines are referenced, discussing various recommended therapies and the complexities of patient response to treatment. Schlesinger notes the challenges of keeping patients on treatment due to adverse effects and the importance of monitoring for these events. The potential for neoadjuvant therapy to convert inoperable cases into surgical candidates is also explored, underscoring the evolving nature of treatment protocols. Additionally, he addresses patient management strategies in both immunocompetent and immunocompromised populations, while advocating for continuous research and adaptation of treatment approaches in private practice settings.