LB939 Novel recommendations to minimize cSCC risk in SOTR

Solid organ transplant recipients (SOTR) are at significantly increased risk for the development of cutaneous squamous cell carcinomas (cSCCs). Based on previously published data, our Columbia University Cutaneous Oncology Group has developed novel clinical management guidelines aimed reducing cSCCs in SOTR. Currently data contain following broad recommendations that may reduce SOTR: 1) Use mTOR inhibitors, particularly sirolimus, conjunction with mycophenolate, compared to alternative immunosuppressants; 2) Chemoprevention acitretin and niacinamide (limited is available use immunocompromised patients); 3) capecitabine (small case series have shown reduction SOTR). above group proposes algorithm: Considering excellent safety profile niacinamide, all SOTR factors skin cancers should start niacinamide; For 1 low-risk cSCC/year, AJCC/BWH stage T1, continue consider adding acitretin. 2-10 cSCCs/year, add immunosuppression modification. 4) >10 capecitabine. 5) high-risk cSCC, AJCC T3 or BWH T2B, acitretin, 6) ≥2 cSCCs, Niacinamide efficacious immunocompetent patients an profile. Therefore, early administration SOTR, recognizing need additional investigation dedicated trials focused this population. Our institutional allow algorithmic standardized approach current preventative paradigm enable building a unified platform future studies.