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Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
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Immune Checkpoint Inhibitors for Advanced Cutaneous Squamous Cell Carcinoma: A Systematic Review with Meta-Analysis

Neil K Mehta1, Andraia R Li2, Shaun A Nguyen2

  • 1Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA. mehtan@musc.edu.

Targeted Oncology
|October 22, 2021
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICIs) show a 42.43% objective response rate in advanced cutaneous squamous cell carcinoma (CSCC). Further trials are needed to determine long-term survival and durability of response for this CSCC treatment.

Area of Science:

  • Oncology
  • Immunotherapy
  • Dermatology

Background:

  • FDA approved immune checkpoint inhibitors (ICIs) for advanced and recurrent/metastatic (R/M) cutaneous squamous cell carcinoma (CSCC) based on early trials.
  • Updated data from these pivotal trials are still pending, leaving the extent of survival outcomes undetermined.

Purpose of the Study:

  • To assess the efficacy of ICIs in advanced CSCC, including locally advanced (LA), locoregionally advanced (LR), and R/M disease.
  • Evaluate response rates, disease control, duration of response, and tolerability of ICIs in CSCC.

Main Methods:

  • Systematic review of four databases (PubMed, Scopus, OVID, Cochrane) and meta-analysis of proportions.
  • Inclusion of Phase I and II prospective clinical trials evaluating ICIs for CSCC.
  • Pooled analysis of data from six trials involving cemiplimab and pembrolizumab.

Main Results:

  • Pooled analysis of 392 patients showed an objective response rate (ORR) of 42.43% and a disease control rate (DCR) of 58.05% with ICIs.
  • Patients with locoregionally advanced or distant metastatic lesions had comparable ORRs and DCRs.
  • Duration of response was not reached; 92% of responders maintained response. Grade ≥3 adverse events occurred in 27.12% of patients.

Conclusions:

  • ICIs demonstrate promising efficacy for locally advanced, locoregionally advanced, and recurrent/metastatic CSCC unsuitable for surgery.
  • Surgical treatment remains the standard of care for resectable CSCC.
  • Further trials are warranted to explore neoadjuvant/adjuvant ICI therapy combined with local treatments to assess survival and response durability.

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