Review of Systemic Agents in the Treatment of Advanced Cutaneous Squamous Cell Carcinoma

Abstract

Advanced cutaneous squamous cell carcinoma (cSCC) accounts for only 5% of all cases of cSCC but up to 60% of disease related deaths. Historically, this disease has lacked effective treatment options due to a combination of poor response rate, poor response durability and significant treatment-associated morbidity. Autumn of 2018 marked the first time ever that an agent received US FDA approval for advanced cSCC and the future is looking much brighter for this previously neglected patient population. The purpose of this article is to review the various systemic treatment options for advanced cSCC moving from the past to the present, highlighting their relative merits and shortcomings, and to briefly speculate on future developments in the field of advanced cSCC.

Successful treatment of recurrent advanced cutaneous squamous cell carcinoma with cemiplimab

“…With a variable clinical presentation and lack of standardized guidelines, the management of advanced locally aggressive cutaneous squamous cell carcinoma remains clinically challenging [5]. Immunotherapy with cemiplimab, a recently approved PD1 inhibitor, is an important addition to the cutaneous oncology armamentarium that may be considered in patients with advanced disease not amenable to surgery.…”

Cutaneous Squamous Cell Carcinoma: From Biology to Therapy

“…These autoimmune side-effects may sometimes be severe and force a treatment cycle to be discontinued or even withdrawn. Headache, pruritus, and dermatitis may be expected as well [128].…”

Clinicopathological characteristics and clinical morbidity in high‐risk head and neck cutaneous squamous cell carcinoma patients in Western Australia

“…In 2018, cemiplimab was approved by the United States Food and Drug Administration (FDA) as the first immunotherapy agent for the treatment of metastatic or locally advanced cSCC not amenable to curative treatment 13,29–32 . Recent updated data from the landmark phase II trial in patients with advanced cSCC demonstrated durable significant clinical responses and an increasing number of complete responses 33 .…”

“…In 2018, cemiplimab was approved by the United States Food and Drug Administration (FDA) as the first immunotherapy agent for the treatment of metastatic or locally advanced cSCC not amenable to curative treatment. 13,[29][30][31][32] Recent updated data from the landmark phase II trial in patients with advanced cSCC demonstrated durable significant clinical responses and an increasing number of complete responses. 33 With a median follow up of 15.7 (range 0.6-36.1) months, the objective response rate was reported as 46.1% (95% CI: 38.9-53.4), the number of complete responses had increased from 7% to 16.1%, the durable disease control rate was 61% (95% CI: 53.3-67.6) and median OS was not reached.…”