How should medical oncologists and dermatologists communicate about patients with at least Stage IIB/III cutaneous melanoma regarding neoadjuvant immunotherapy?
Some medical oncologists may get referrals for patients after a shave biopsy leads to WLE, thus removing the primary and its opportunity for antigens to be present, and may not be aware of the T stage, given a shave biopsy on diagnosis. What have you or your institution done in practice to facilitate these referrals?
1 Answer
Mednet MemberInvited Expert
Medical Oncology · The Ohio State University Comprehensive Cancer Center
Answered on
Only melanoma patients with stage III or resectable stage IV disease should be treated with standard-of-care neoadjuvant immunotherapy.
These patients should see a medical oncologist first (and no longer last, as is the current process). I would recommend that the schedulers at your institution be educated to make this happen. It takes months, if not years, to change habits...
Also, surgeons need to be aware of the guidelines, and they may not always be, especially if they are not melanoma surgeons. Thus, education with review of the NCCN guidelines at multidisciplinary meetings could be helpful.
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