The Role of Neoadjuvant Immunotherapy and Multidisciplinary Communication

The faculty consider whether neoadjuvant checkpoint inhibitor therapy has a role in cutaneous squamous cell carcinoma, particularly for tumors that are borderline resectable or would require morbid surgery. Dr Whitman notes that this patient population differs from other solid tumor populations, with fewer competing malignancies and a distinct set of surgical considerations. The faculty discuss the potential for systemic therapy to downstage bulky disease and convert an unresectable presentation into an operable one, and the importance of reassessing surgical candidacy as the tumor responds rather than treating the initial determination as fixed. Dr Whitman, speaking from a surgical oncology perspective, emphasizes ongoing communication between the medical oncologist and the operating surgeon throughout treatment. Both faculty stress that multidisciplinary evaluation should continue after systemic therapy begins, since the clinical situation can change substantially and the right intervention may shift accordingly.