Both panelists describe multidisciplinary care coordination models. Dr. Zeitouni describes virtual tumor boards as one pandemic-era advancement that has improved access to multidisciplinary input across practice settings, enabling community-based dermatologists and Mohs surgeons to present cases to medical oncologists and radiation oncologists without geographic constraints. For community practices without formal tumor board infrastructure, establishing direct collegial relationships with medical oncologists who have cutaneous malignancy expertise via phone, text, or referral achieves similar coordination benefits.
NP Schollenberger describes Hopkins’ weekly tumor board including surgeons, dermatologists, medical oncologists, and radiation oncologists, supported by direct inter-specialty communication as needed. Her team is piloting a HIPAA-secure mobile application developed through their group (1104 Health) that connects community providers with academic specialists, enabling direct patient-level communication and allowing patients to receive treatment locally while maintaining involvement of cutaneous malignancy specialists.
Regarding biomarkers, Dr. Zeitouni highlights two emerging tools. Gene expression profiling for CSCC provides a prognostic risk stratification (low, intermediate, or high risk of metastasis at 3 years), guiding surveillance intensity and imaging frequency. Circulating tumor DNA liquid biopsy, with established utility in melanoma and Merkel cell carcinoma, is beginning to be used in CSCC for treatment response monitoring and disease surveillance using tumor-informed assays.
