Perioperative Systemic Therapy for High-Risk Cutaneous Squamous Cell Carcinoma.

Area of Science:

• Oncology
• Dermatology
• Immunotherapy

Background:

• Cutaneous squamous cell carcinoma (CSCC) incidence is increasing.
• High-risk CSCC requires therapies beyond surgery.
• Systemic therapies, including immunotherapy, are being studied in the perioperative setting.

Purpose of the Study:

• To review the evolving role of neoadjuvant and adjuvant immunotherapy for high-risk CSCC.
• To highlight the efficacy and ongoing research of immunotherapy in CSCC treatment.

Main Methods:

• Review of systemic therapies for CSCC, focusing on immunotherapy agents like cemiplimab, pembrolizumab, and atezolizumab.
• Analysis of studies investigating neoadjuvant and adjuvant immunotherapy in the perioperative setting.
• Evaluation of response rates, survival data, and safety profiles.

Main Results:

• Immunotherapy, particularly programmed cell death protein/ligand-1 inhibitors, has revolutionized advanced CSCC treatment.
• Cemiplimab demonstrated significant pathologic response rates (64-75%) in the neoadjuvant setting and improved survival in the adjuvant setting.
• Other agents like pembrolizumab and atezolizumab are also under investigation.

Conclusions:

• Neoadjuvant and adjuvant immunotherapy represent promising treatment options for high-risk CSCC.
• Further research is needed to optimize treatment regimens, predict responders, establish long-term data, and study special populations.