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Updated: Jul 11, 2025
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Epidermal growth factor receptor inhibitors in advanced cutaneous squamous cell carcinoma: A systematic review and
James P Pham1,2, Anthony Rodrigues1,2, Simone M Goldinger3
1Department of Medical Oncology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.
Abstract:
Patients with advanced cutaneous squamous cell carcinoma (cSCC) who are not eligible for or who fail to respond to anti-PD1 immunotherapy have few treatment options. Epidermal growth factor receptor (EGFR) inhibitors have been investigated as a therapeutic option for advanced cSCC; however, data are limited to small single-arm trials or retrospective studies. A systematic review and meta-analysis was conducted to PRISMA guidelines (CRD42023394300). Studies reporting on outcomes of EGFR inhibition in advanced cSCC were identified. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and adverse event (AE) rate were pooled using a random effects model and the inverse variance method. Twelve studies (six prospective, six retrospective) were identified, representing 324 patients. Pooled ORR was 26% (95% confidence interval [CI] 18-36), median PFS was 4.8 months (95% CI 3.9-6.6) and median OS was 11.7 months (95% CI 9.2-14.1). Any grade AEs occurred in 93% of patients (95% CI 85-97) while grade 3 and higher AEs occurred in 30% (95% CI 14-54). These results were similar between anti-EGFR monoclonal antibodies (MAbs) and tyrosine kinase inhibitors (TKIs). EGFR inhibitors can be considered in patients with advanced cSCC who are contraindicated for or progress on first-line anti-PD1 immunotherapy. Future studies should evaluate their activity and safety following anti-PD1, identify predictive biomarkers for their efficacy and explore combination approaches.
Insights
Epidermal growth factor receptor (EGFR) inhibitors show a 26% objective response rate in advanced cutaneous squamous cell carcinoma (cSCC) patients resistant to anti-PD1 therapy. While associated with significant adverse events, they offer a viable treatment option.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Advanced cutaneous squamous cell carcinoma (cSCC) presents limited therapeutic options for patients unresponsive to anti-PD1 immunotherapy.
- Epidermal growth factor receptor (EGFR) inhibitors are being explored, but evidence from small trials necessitates further investigation.
Approach:
- A systematic review and meta-analysis adhering to PRISMA guidelines was performed.
- Data from 12 studies (324 patients) on EGFR inhibition in advanced cSCC were analyzed.
- Pooled objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse event (AE) rates were calculated.
Key Points:
- Pooled ORR was 26% (95% CI 18-36), median PFS was 4.8 months (95% CI 3.9-6.6), and median OS was 11.7 months (95% CI 9.2-14.1).
- Any grade AEs occurred in 93% of patients, with 30% experiencing grade 3 or higher AEs.
- Efficacy and safety profiles were comparable between anti-EGFR monoclonal antibodies (MAbs) and tyrosine kinase inhibitors (TKIs).
Conclusions:
- EGFR inhibitors represent a potential treatment strategy for advanced cSCC patients progressing on or contraindicated for anti-PD1 immunotherapy.
- Further research is warranted to assess activity and safety post-anti-PD1 therapy, identify predictive biomarkers, and explore combination therapies.
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