Medications

Many medicines can be used to treat skin cancer. The type used will depend on the type of skin cancer, the stage of the cancer, and the person’s overall health.¹

Some of the drugs used to treat skin cancer include:¹

• Chemotherapy – Uses drugs to kill cancer cells
• Targeted therapy – Uses drugs to target specific molecules on cancer cells
• Immunotherapy – Uses the body's immune system to fight cancer
• Topicals – Applied directly to the skin to treat skin cancer

Melanoma

Drugs are used to treat melanoma when it:²

• Cannot be removed with surgery (unresectable) or
• Has spread to distant parts of the body (metastasized).

Drugs can be used as adjuvant treatment for advanced melanomas. This is given after the primary treatment. The goal is to kill cancer cells that may have spread to other body parts. Adjuvant therapy can be given after surgery, radiation therapy, or chemotherapy.²

Targeted therapy

Targeted therapies target specific molecules involved in the growth and spread of melanoma cells. These molecules include:²

• BRAF – A gene that is often mutated in melanoma cells
• MEK – A protein that helps BRAF to work
• KIT – A protein found on some melanoma cells' surface

Targeted therapies that treat melanoma with BRAF mutations include:²

• Tafinlar^® (dabrafenib), possibly in combination with Mekinist^® (trametinib), a MEK inhibitor
• Zelboraf^® (vemurafenib), possibly in combination with Cotellic^® (cobimetinib), another MEK inhibitor
• Braftovi (encorafenib) and Mektovi (binimetinib), a combination targeted therapy to treat melanoma that cannot be surgically removed or metastatic melanoma with a BRAF V600E or V600K mutation
• Gleevec^® (imatinib), which may be used for advanced melanoma with c-KIT mutation

Immunotherapy

Drugs called immune checkpoint inhibitors prevent melanoma cells from hiding from your immune system. These medicines include:²

• Keytruda^® (pembrolizumab)
• Opdivo^® (nivolumab)
• Yervoy^® (ipilimumab)
• Tecentriq^® (atezolizumab), used together with vemurafenib and cobimetinib targeted therapies
• Opdualag^® (nivolumab and relatlimab-rmbw)

Other forms of immunotherapy used to treat melanoma include:²

• Interleukin-2
• Intralesional talimogene laherparepvec
• Intralesional Bacillus Calmette-Guerin (BCG) vaccine

Chemotherapy

This treatment is an option for some people. But chemotherapy is not usually the first choice for treatment.²

Basal cell carcinoma (BCC)

Topical drugs can be used to treat some BCC if surgery, curettage and electrodesiccation, or radiation therapy are not possible. These are applied to the skin.³

Approved options for thin BCC include:³

• Fluorouracil
• Imiquimod

These drugs are only used for BCC that is unlikely to return (recur). For higher-risk BCC, more effective treatments are available.³

Targeted therapies are available to treat certain forms of advanced BCC. They include:³

• Odomzo^® (sonidegib)
• Erivedge^® (vismodegib)
• Libtayo^® (cemiplimab-rwlc)

Squamous cell carcinoma (SCC)

Squamous cell carcinoma in situ (SCC or Bowen’s disease) may be treated with topical drugs. Two of these drugs include:³

• Fluorouracil
• Imiquimod

Chemotherapy may be used with radiation therapy for SCC which is likely to return. This may be used if surgery is not an option or if it has spread to lymph nodes.³

Libtayo and Keytruda may be used to treat certain forms of advanced SCC.³

Actinic keratosis

Topical drugs are used to treat actinic keratosis. Drugs approved include:⁴

• Fluorouracil
• Imiquimod
• Diclofenac
• Ingenol mebutate

Merkel cell carcinoma (MCC)

As of June 2023, the checkpoint inhibitors used to treat MCC include:⁵

• Bavencio^® (avelumab)
• Opdivo^® (nivolumab)
• Keytruda^® (pembrolizumab)
• Zynyz™ (retifanlimab)

Chemotherapy may also be used to shrink or slow the spread of MCC.⁶

Kaposi sarcoma

Chemotherapy is a standard treatment for Kaposi sarcoma. If only a few lesions exist, the drug may be injected directly into them. If the cancer is widespread, chemotherapy may be used systemically.⁷

Liposomal doxorubicin is the main chemotherapy drug for Kaposi sarcoma.⁷

Pomalyst^® (pomalidomide) may be used as an immunotherapy to treat certain forms of Kaposi sarcoma.⁷