Successful treatment of recurrent advanced cutaneous squamous cell carcinoma with cemiplimab

Cervantes, Jose A; Fox, Matthew C.

doi:10.5070/d32610050463

Cited by 11 publications

(9 citation statements)

References 6 publications

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“…Of particular note, cases of grade II and grade III tumors nearly tripled between 1975 and 2015 (Figure 2). Therefore, cases of aggressive cSCC appear to be increasing over time, and this is a finding congruent with our clinical experience and recently published reports . This represents a newly found trend in cSCC of the lip across the past 40 years, as previous reports found an equivalent number of grade II or III tumors out of total cases collected …”

Section: Discussionsupporting

confidence: 92%

“…Therefore, cases of aggressive cSCC appear to be increasing over time, and this is a finding congruent with our clinical experience and recently published reports. 37,38 This represents a newly found trend in cSCC of the lip across the past 40 years, as previous reports found an equivalent number of grade II or III tumors out of total cases collected. 20 One explanation for this trend of increasingly aggressive cSCC of the lip is the use of immunosuppressive agents among patients.…”

Section: Clinical Characteristicssupporting

confidence: 69%

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Trend Analysis of Cutaneous Squamous Cell Carcinoma of the External Lip From 1975 to 2016

Mehta

Nguyen

Chang

et al. 2021

JAMA Otolaryngol Head Neck Surg

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utaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer, with an incidence between 5 and 96 per 100 000 individuals. 1,2 Most patients with this malignant neoplasm are diagnosed early and treated surgically with disease-free survival. However, between 3.7% and 5.8% of cases metastasize, leading to 4000 to 9000 deaths annually in the United States. 3 Cutaneous SCC of the head and neck (cHNSCC) is a primary site of special concern. Commonly affected sites in this region are the external lip and ear. Cutaneous HNSCC accounts for up to 49% to 60% of all cSCC cases, and the anatomical structures of this region predispose to high morbidity with invasive tumors. [4][5][6][7] Analyses of cSCC have found a strong correlation between UV radiation and immunosuppression with disease incidence. 2,5,8,9 These risk factors contribute to the varying in-cidence found within populations, with patients exposed to immunosuppressive drugs or higher UV index more likely to develop this malignant neoplasm. As such, geography is an important risk factor for patients. Individuals living in the more southern regions of the United States have traditionally been targeted as an at-risk group.Localized cases of cSCC are treated surgically, with minimum margins of 4.0 mm (T1) or 6.0 mm (T2) and are curative in 95% of cases. 6 Locally advanced tumors, T3 or greater, are at least 4 cm in size or invade bone or perineural structures. 2 These malignant neoplasms are almost always treated surgically, with either standard excision or Mohs micrographic surgery. Perineural invasion occurs in 2% to 14% of cases, with a high risk of recurrence (47%) and metastasis (35%). 10 Treatment of metastatic disease is multidisciplinary; lymphadenec-IMPORTANCE Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer and commonly affects the head and neck. Increasing regional reports of aggressive cases warrant an analysis of population-based trends of cSCC of the head and neck. OBJECTIVE To assess demographic, clinical, and survival trends among patients with cSCC of the external lip. DESIGN, SETTING, AND PARTICIPANTS This was a retrospective, population-based cohort study of 15 171 cases of cSCC of the external lip registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Statistical analyses were conducted in October 2020. MAIN OUTCOMES AND MEASURESThe primary outcome was clinical characteristics (tumor site, stage, and tumor grade). Demographic characteristics, incidence, treatment characteristics, and survival outcomes were also assessed. RESULTSIn total, 15 171 cases of cSCC were extracted from the SEER database (80.3% of patients were male, and 97.0% identified as being of White race/ethnicity). Incidence among male patients decreased from 4.4 to 0.8 per 100 000 during the study period, whereas the female patients' share cases increased from 8.4% in 1975 to 1979 to 26.1% by 2016. Cases increased in the US Pacific Coast and eastern regions, and along...

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Section: Discussionsupporting

confidence: 92%

Section: Clinical Characteristicssupporting

confidence: 69%

Trend Analysis of Cutaneous Squamous Cell Carcinoma of the External Lip From 1975 to 2016

Mehta

Nguyen

Chang

et al. 2021

JAMA Otolaryngol Head Neck Surg

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“…The evidence for immunotherapy in periocular SCC with PNI has been promising, but scant. There was one case report of a primary suprabrow SCC with orbital extension that recurred following radical surgical resection and radiotherapy, and was eventually amenable to cemiplimab [94]. A separate case series investigated the efficacy of pembrolizumab and cemiplimab for head and neck cSCC with perineural spread that was refractory to prior radical treatments [68].…”

Section: Zone 3 Diseasementioning

confidence: 99%

Perineural invasion and perineural spread in periocular squamous cell carcinoma

Tong

Huilgol

James³

et al. 2022

Eye

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Perineural invasion (PNI) in cutaneous squamous cell carcinoma (SCC) of the periocular region is a prognostic marker of adverse tumour outcomes. PNI carries a well-established risk of tumour recurrence, regional metastasis and higher likelihood of mortality. This review will explore and stratify the risks conferred by histological PNI parameters. The radiological features of perineural spread (PNS) and the imaging sequences that delineate these findings will also be highlighted. Surgical excision with en face margin control is the preferred technique for achieving histological clearance. Adjuvant radiotherapy improves treatment outcomes in the setting of concomitant high-risk features. For locally advanced or metastatic cutaneous SCC, immunotherapy represents a novel treatment alternative. This review will provide an algorithm for the diagnosis and management of periocular SCC with PNI and PNS.

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“…Novel therapies, such as inhibitors of the transmembrane protein programmed cell death protein 1 (PD1), were approved in 2018 for the treatment of advanced cutaneous SCC [47]. To date, these have shown promising results in patients with poor prognosis, but only a few case reports have described PD-1 inhibitors in the treatment of SCC with PNI [48][49][50]. Stevenson et al investigated PD-1 and PD-L2 (PD ligand) expression in biopsy specimens of cutaneous SCC by immunohistochemistry.…”

Section: Therapy Of Squamous Cell Carcinoma With Perineural Invasionmentioning

confidence: 99%

Hide‐and‐seek: Neurotropic squamous cell carcinoma of the periorbital region – a series of five cases and review of the literature

Morandi

Rauchenwald

Puelzl

et al. 2021

J Deutsche Derma Gesell

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Summary Squamous cell carcinoma is the second most common malignancy of the skin after basal cell carcinoma and mainly found in sun‐exposed areas such as the face. This mostly locally destructive malignancy may show invasive growth and insidious mechanisms of dissemination such as perineural invasion. Periorbital squamous cell carcinoma is associated with perineural invasion in up to 14 % of cases. Specifically in this region, the proximity to cranial nerves and therefore the associated risk of progression to the central nervous system are associated with poor prognosis. The clinically concealed character of this entity often leads to a delay in diagnosis and consequently makes complete resection and reconstruction demanding. Careful clinical evaluation often hints at perineural invasion before obtaining histology. Aside from presenting five challenging cases, this work analyzes risk factors, clinical as well as histological features, and treatment options for periorbital squamous cell carcinoma with perineural invasion.

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Successful treatment of recurrent advanced cutaneous squamous cell carcinoma with cemiplimab

Cited by 11 publications

References 6 publications

Trend Analysis of Cutaneous Squamous Cell Carcinoma of the External Lip From 1975 to 2016

Trend Analysis of Cutaneous Squamous Cell Carcinoma of the External Lip From 1975 to 2016

Perineural invasion and perineural spread in periocular squamous cell carcinoma

Hide‐and‐seek: Neurotropic squamous cell carcinoma of the periorbital region – a series of five cases and review of the literature

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