New Immunotherapy Advances and Multidisciplinary Care Strategies for Advanced Skin Cancer: Todd Schlesinger, MD

This content was developed independently and is not endorsed by the American Academy of Dermatology.

Rapid progress in immuno-oncology is changing how clinicians manage patients with locally advanced and metastatic skin cancers, particularly high-risk squamous cell carcinoma. In an interview at the American Academy of Dermatology (AAD) 2026 Annual Meeting, Todd Schlesinger, MD, founder and director of both the Dermatology & Laser Center of Charleston and the Clinical Research Center of the Carolinas, highlighted the importance of improving risk stratification and integrating emerging immunotherapies within multidisciplinary care models.

A foundational step in optimizing outcomes is rigorous risk assessment, according to Schlesinger. Clinicians must identify patients at highest risk for local recurrence, perineural involvement, and regional or distant metastases. These risk profiles not only guide surveillance intensity but also determine which individuals may benefit most from systemic therapy beyond surgery and radiation.

For patients who are poor candidates for surgery or radiotherapy, or whose disease characteristics warrant additional systemic control, immunotherapy is increasingly central. Agents such as cemiplimab (Libtayo; Regeneron Pharmaceuticals), now approved as adjuvant treatment after surgery and radiation for squamous cell carcinoma, are supported by data from the C-POST (NCT03969004) study, which showed a statistically significant benefit vs placebo in high-risk patients.

A newer entrant, cosibelimab (Unloxcyt; Sun Pharma), adds to the expanding toolbox for advanced cutaneous squamous cell carcinoma. By targeting PD‑L1 on tumor cells, in contrast to PD‑1–directed approaches on T cells, cosibelimab offers an alternative mechanism within the same immune checkpoint pathway. Recent data, including approximately 2-year follow-up and updated label information, underscore evolving evidence around safety and efficacy as this agent moves into broader clinical use.

Schlesinger stressed that optimal application of these therapies depends on multidisciplinary care. Dermatologists should remain central in ongoing management while collaborating closely with surgical, radiation, and medical oncology, as well as social workers, advanced practice providers, office staff, and patients’ families. Advanced skin cancer should not be managed in isolation; instead, coordinated multidisciplinary teams are essential to align risk assessment, treatment selection, toxicity management, and supportive care in an era of rapidly advancing immunotherapy options.