Immunotherapy and other systemic therapies for cutaneous SCC

Area of Science:

• Oncology
• Dermatology
• Immunotherapy

Background:

• Cutaneous Squamous Cell Carcinoma (CuSCC) is a significant cause of cancer mortality, often affecting elderly or immunocompromised patients.
• Systemic therapies for advanced CuSCC have historically shown limited durable responses.
• Previous treatments include cytotoxic chemotherapy, EGFR inhibitors, and interferon/retinoids with variable efficacy.

Purpose of the Study:

• To review current systemic therapies for advanced Cutaneous Squamous Cell Carcinoma (CuSCC).
• To highlight the efficacy and durability of novel immunotherapy approaches, specifically checkpoint inhibitors.
• To discuss future directions and the role of immunotherapy in special populations.

Main Methods:

• Review of existing literature on systemic therapies for CuSCC.
• Analysis of response rates and durability data from clinical trials, particularly for immunotherapy.
• Focus on checkpoint inhibitors like PD-1 antibodies.

Main Results:

• Cytotoxic chemotherapy and EGFR inhibitors show activity but lack durable responses.
• Checkpoint inhibitors, such as PD-1 antibodies (e.g., cemiplimab), demonstrate significant response rates (around 40%) with encouraging durability (over a year in 75% of responders).
• Immunotherapy represents a promising advancement in managing advanced CuSCC.

Conclusions:

• Immunotherapy, especially PD-1 checkpoint inhibition, offers a more durable treatment option for advanced CuSCC.
• Further research is needed to optimize immunotherapy strategies and explore their role in specific patient groups.
• Checkpoint inhibitors are transforming the treatment landscape for this potentially deadly skin cancer.