Efficacy and Tolerance of Cetuximab Alone or Combined with Chemotherapy in Locally Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: An Open Study of 14 Patients

Abstract

Background/Aims: Previous reports highlighted the potential interest of cetuximab alone or in combination with chemotherapy in locally advanced or metastatic cutaneous squamous cell carcinomas (cSCC) care. Material and Methods: To further evaluate the efficiency and safety of cetuximab in advanced cSCC, a single-center retrospective study including all patients treated with cetuximab alone or combined with carboplatin for locally advanced or metastatic cSCC was conducted in a tertiary referral center. The primary end point was the overall response rate (ORR) after 2 cycles of treatment. Secondary end points were best overall disease control rate (DCR), overall survival (OS), best response duration, progression-free survival (PFS), and toxicity profile. Results: Of the 14 enrolled patients, no complete response was obtained after 2 cycles of treatment, but 3 partial responses and 6 stable diseases were observed. ORR and DCR were 21.4 and 64.3%, respectively. Median OS and PFS were 9.25 and 2.65 months, respectively. Median PFS was longer with combined treatment compared with cetuximab monotherapy (9.03 vs. 3.55 months). The safety profile was acceptable with a trend toward a relationship between acne-like rash and longer response (median PFS 5.2 vs. 2.2 months). Discussion/Conclusion: In all series including ours, disease control is usually rapidly obtained with cetuximab alone or combined with conventional chemotherapy, although with a minority of partial responses and no complete response. However, this control is of short duration in most cases. The safety profile is acceptable. A randomized phase III trial is warranted to better assess the benefit/risk ratio.

European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 2. Treatment

“…Small number of patients in prospective studies [96,103]. A small number of patients with mcSCC treated [93,97,98,103,109]. Only two prospective nonrandomised study in small number of patients [3,103].…”

Cetuximab is efficient and safe in patients with advanced cutaneous squamous cell carcinoma: a retrospective, multicentre study

“…Cetuximab has been tested in advanced cSCC and demonstrated a DCR of 69% at 6 weeks [11][12][13][14]. Additionally, there is a rationale based on preclinical data to block the programmed cell death protein 1 (PD-1) and/ or the PD-1 ligand (PD-L1) pathway in inoperable cSCC.…”

Nation-wide survey of advanced non-melanoma skin cancers treated at dermatology departments in Japan

“…As shown in Fig. 2B, the most anticipated drug was EGFR inhibitor followed by ICI, both of which have recently been reported to be effective for SCC treatment [24,25]. Currently, several clinical trials using cetuximab and pembrolizumab are ongoing (clinicaltrials.gov) and we hope that patients will benefit from these new drugs in the future.…”