Paul Nghiem, MD, PhD, leads research at the UW Medicine South Lake Union (SLU) campus, and provides patient care at the Fred Hutch Cancer Center.

Paul Nghiem, MD, PhD

New Therapeutic Options in Cutaneous Oncology for 2026, With Paul Nghiem, MD, PhD

 spoke with Paul Nghiem, MD, PhD, of the University of Washington Medicine South Lake Union (SLU) and the Fred Hutch Cancer Center, regarding the takeaways from his conference talk titled ‘Cutaneous Oncology Update 2026.

The presenters of this talk highlighted management strategies and therapeutic agents for actinic keratoses (AKs) and other conditions. In his previous interview segment, Nghiem described the most important advances his fellow panelists highlighted in the management of actinic keratoses and early non-melanoma skin cancers. This segment featured a discussion of advanced disease, especially advanced basal cell carcinoma and squamous cell carcinoma, and newer therapeutic options or strategies most influencing treatment decisions.

“For advanced basal cell carcinoma and squamous cell carcinoma, the trickiest area and most promising is when to use immune therapy,” Nghiem said. “Surgery and radiation are early management keys, but now there's evidence that immune therapy can be helpful in at least a subset of those cancers, including squamous cell carcinoma, in patients who have regionally advanced.”

Among patients with lymph nodes and very advanced squamous cell carcinoma, after surgery and after radiation, adding adjuvant immunotherapy can be beneficial, Nghiem expressed. However, he noted, clinicians should take careful consideration of the risks and benefits. In their talk, Nghiem and his colleagues also covered rarer but aggressive tumors like Merkel cell carcinoma. He was asked in his interview what some key developments clinicians should be aware of were, especially around diagnosis, staging, and systemic treatment.

“I think one of the really exciting developments in Merkel cell carcinoma is how we track it,” Nghiem said. “It's going to come back in 40% of patients, and almost all of those recurrences are within 2 to 3 years. Finding the recurrence earlier is beneficial because it gives us more time, more shots on goal to treat it effectively.”

Nghiem described the first immunotherapy as only working in around half of patients, noting the need to often consider alternatives. Finding such a cancer before it comes back earlier is advantageous, he noted, and there are now 2 blood tests designed to help with tracking.

One such test, Nghiem said, is the antibody blood test for the virus. The other is circulating tumor DNA (ctDNA).

 The tests can be implemented together or by themselves, if only one is available for a given patient. Both tests were described by Nghiem as more sensitive and specific than scans.

The quotes used in this interview summary were edited for clarity.

Nghiem previously reported personal fees from Rain Therapeutics, EMD Serono, Pfizer, Sanofi/Regeneron, 4SC, and Merck; grants from EMD Serono and Bristol Myers Squibb to his institution; and a patent for Merkel cell polyomavirus T antigen–specific T-cell receptors and uses thereof pending (University of Washington), as well as a patent for novel epitopes as T-cell targets in Merkel cell carcinoma pending.

Rosen T, Martin G, Schmults C, Nghiem P, et al. Cutaneous Oncology Update 2026. Presented at the 2026 Maui Derm Hawaii Conference, January 25-29.

de Abreu AR, Wyninckx A, Benhaim L, et al. Circulating Tumor DNA detection in cancer: a comprehensive overview of current detection methods and prospects. Oncologist. 2025 Sep 1;30(9):oyaf204. doi: 10.1093/oncolo/oyaf204. PMID: 40680231; PMCID: PMC12450317.

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This interview segment continues with Paul Nghiem, MD, PhD, highlighting notable insights from his session on cutaneous oncology.

Cutaneous Oncology Updates for 2026, With Paul Nghiem, MD, PhD

Paul Nghiem, MD, PhD, of the University of Washington Medicine South Lake Union (SLU) and Fred Hutch Cancer Center, spoke with the 

 editorial team in a recent interview at the 

Nghiem had been 1 of several panelists who presented a session at Maui Derm titled ‘Cutaneous Oncology Update 2026,’ during which the speakers highlighted management strategies and therapeutic options for the treatment of actinic keratoses (AKs), non-melanoma skin cancers sucb as Merkel cell carcinoma, and other conditions.

“Probably the biggest update in recent years has been the optimal use of immune therapy for Merkel cell carcinoma, in particular,” Nghiem explained. “But you know, almost all the cancers, cutaneous, squamous, and melanoma, of course, have been transformed by that. In Merkel, in particular, there's a different set of challenges that come along for dermatologists, because the dermatologist can really help to navigate the landscape.”

Frequently, radiation, surgery, or immune therapy can be provided to such patients. Such treatmets, Nghiem noted, needs to be customized. The dermatologist does not play the dominant role for any of these 3 options. Nghiem notes the dermatologist can, however, be the real advocate for the patient and the most knowledgeable person in the room regarding some of the more rare cancers such as Merkel cell carcinoma (MCC) and sebaceous carcinoma.

Nghiem was later asked what the most important advances highlighted in his session were related to the management of actinic keratoses and early non-melanoma skin cancers. Additionally, he was asked how such changes might impact everyday dermatology practice.

“Perhaps one of the more important things in managing actinic keratosis is the combination of 5-Fluorouracil plus calcipotriol,” Nghiem expressed.

5-Fluorouracil (5-FU) combined with calcipotriol is often referred to as 5-FU + calcipotriene.

 The treatment should not, Ngiem pointed out, be given to patients for more than 4 days time, as opposed to 5-Fluoraracil, which can often be given for weeks at a time. Nghiem highlighted 5-FU + calcipotriene as highly potent and effective in only 4 days, cautioning against over treating.

The quotes contained in this video summary were edited for the purposes of clarity.

Nghiem has previously reported personal fees from Rain Therapeutics, EMD Serono, Pfizer, Sanofi/Regeneron, 4SC, and Merck; grants from EMD Serono and Bristol Myers Squibb to his institution; and a patent for Merkel cell polyomavirus T antigen–specific T-cell receptors and uses thereof pending (University of Washington), as well as a patent for novel epitopes as T-cell targets in Merkel cell carcinoma pending.

Dlott AH, Spencer SA, Di Pasqua AJ. Calcipotriol and 5-Fluorouracil Combination Therapy for the Treatment of Actinic Keratosis in the Clinic: A Review Article. Clin Drug Investig. 2024 Oct;44(10):733-737. doi: 10.1007/s40261-024-01392-w. Epub 2024 Sep 28. PMID: 39342018; PMCID: PMC11499312.

Paul Nghiem highlights several key takeaways from his talk on cutaneous oncology, touching on various advances in skin cancer management.

Paul Nghiem, MD, PhD

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